Global increase and geographic convergence in antibiotic consumption between 2000 and 2015.
Eili Y. Klein,Eili Y. Klein,Thomas P. Van Boeckel,Elena Martinez,Suraj Pant,Sumanth Gandra,Simon A. Levin,Herman Goossens,Ramanan Laxminarayan,Ramanan Laxminarayan,Ramanan Laxminarayan +10 more
TLDR
It is found that the antibiotic consumption rate in low- and middle- income countries (LMICs) has been converging to (and in some countries surpassing) levels typically observed in high-income countries, and projected total global antibiotic consumption through 2030 was up to 200% higher than the 42 billion DDDs estimated in 2015.Abstract:
Tracking antibiotic consumption patterns over time and across countries could inform policies to optimize antibiotic prescribing and minimize antibiotic resistance, such as setting and enforcing per capita consumption targets or aiding investments in alternatives to antibiotics. In this study, we analyzed the trends and drivers of antibiotic consumption from 2000 to 2015 in 76 countries and projected total global antibiotic consumption through 2030. Between 2000 and 2015, antibiotic consumption, expressed in defined daily doses (DDD), increased 65% (21.1–34.8 billion DDDs), and the antibiotic consumption rate increased 39% (11.3–15.7 DDDs per 1,000 inhabitants per day). The increase was driven by low- and middle-income countries (LMICs), where rising consumption was correlated with gross domestic product per capita (GDPPC) growth (P = 0.004). In high-income countries (HICs), although overall consumption increased modestly, DDDs per 1,000 inhabitants per day fell 4%, and there was no correlation with GDPPC. Of particular concern was the rapid increase in the use of last-resort compounds, both in HICs and LMICs, such as glycylcyclines, oxazolidinones, carbapenems, and polymyxins. Projections of global antibiotic consumption in 2030, assuming no policy changes, were up to 200% higher than the 42 billion DDDs estimated in 2015. Although antibiotic consumption rates in most LMICs remain lower than in HICs despite higher bacterial disease burden, consumption in LMICs is rapidly converging to rates similar to HICs. Reducing global consumption is critical for reducing the threat of antibiotic resistance, but reduction efforts must balance access limitations in LMICs and take account of local and global resistance patterns.read more
Citations
More filters
Journal ArticleDOI
Pharmaceuticals of Emerging Concern in Aquatic Systems: Chemistry, Occurrence, Effects, and Removal Methods.
TL;DR: Adsorption technologies are a low-cost alternative, easily used in developing countries where there is a dearth of advanced technologies, skilled personnel, and available capital, and adsorption appears to be the most broadly feasible pharmaceutical removal method.
Journal ArticleDOI
Antimicrobial Resistance: Implications and Costs.
TL;DR: The literature review, which included articles published after the year 2012, indicated that the multifactorial threat of antimicrobial resistance has resulted in different complex issues affecting countries across the globe.
Journal ArticleDOI
Occurrence and toxicity of antibiotics in the aquatic environment: A review.
Pavla Kovalakova,Leslie Cizmas,Thomas J. McDonald,Blahoslav Maršálek,Mingbao Feng,Virender K. Sharma +5 more
TL;DR: The risk data indicate that selected antibiotics may pose a threat to aquatic environments, and Cyanobacteria were the most sensitive organisms when using standard ecotoxicological bioassays.
Journal ArticleDOI
Antibiotic pollution in surface fresh waters: Occurrence and effects
TL;DR: Important aspects of antibiotic pollution in fresh waters are highlighted: that concentrations of antibiotics in the environment are substantial, that micro-organisms are susceptible to this, that bacteria can evolve resistance in the environments, and that antibiotic pollution affects natural food webs while interacting with other stressors; which taken together poses a number of challenges for environmental scientists.
Journal ArticleDOI
Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage
Rene S. Hendriksen,Patrick Munk,Patrick Murigu Kamau Njage,Bram A. D. van Bunnik,Luke McNally,Oksana Lukjancenko,Timo Röder,David F. Nieuwenhuijse,Susanne Karlsmose Pedersen,Jette Kjeldgaard,Rolf Sommer Kaas,Philip Thomas Lanken Conradsen Clausen,Josef Korbinian Vogt,Pimlapas Leekitcharoenphon,Milou G.M. van de Schans,T. Zuidema,Ana Maria de Roda Husman,Simon Rasmussen,Bent O. Petersen,Clara Amid,Guy Cochrane,Thomas Sicheritz-Pontén,Heike Schmitt,Jorge Raul Matheu Alvarez,Awa Aidara-Kane,Sünje Johanna Pamp,Ole Lund,Tine Hald,Mark E. J. Woolhouse,Marion Koopmans,Håkan Vigre,Thomas Nordahl Petersen,Frank Møller Aarestrup +32 more
TL;DR: It is suggested that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR.
References
More filters
Journal ArticleDOI
Urbanization and geographic expansion of zoonotic arboviral diseases: mechanisms and potential strategies for prevention.
TL;DR: Urban emergences of dengue, chikungunya, and yellow fever viruses and potential strategies for their prevention and control are reviewed.
Journal ArticleDOI
Antibiotic effectiveness: Balancing conservation against innovation
TL;DR: This paper assesses the relative benefits and costs of conservation and innovation in making the best use of current antibiotic effectiveness.
Journal ArticleDOI
Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals
Lucie Collineau,Catherine Belloc,K. D. C. Stark,Anne Hemonic,Merel Postma,Jeroen Dewulf,Claire Chauvin +6 more
TL;DR: An increasing variety of indicators of antimicrobial usage has become available in human and veterinary medicine, with no consensus on the most appropriate indicators to be used, to provide guidance on the selection of indicators.
Journal ArticleDOI
Variability in Antibiotic Use Across Nursing Homes and the Risk of Antibiotic-Related Adverse Outcomes for Individual Residents.
Nick Daneman,Susan E. Bronskill,Andrea Gruneir,Alice Newman,Hadas D. Fischer,Paula A. Rochon,Paula A. Rochon,Paula A. Rochon,Geoffrey M. Anderson,Geoffrey M. Anderson,Chaim M. Bell +10 more
TL;DR: The primary analysis indicated that residence in a high-use nursing home was associated with an increased risk of a resident experiencing an antibiotic-related adverse event, and a sensitivity analysis examining nursing home-level antibiotic use as a continuous variable confirmed an increasedrisk of resident-level antibiotics-related harms.
Journal ArticleDOI
Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study
Timothy Lawes,J.M. López-Lozano,César Nebot,Gillian Macartney,Rashmi Subbarao-Sharma,Ceri R J Dare,Karen D Wares,Ian M. Gould +7 more
TL;DR: Alongside infection control measures, removal of key antibiotic selection pressures during a national antibiotic stewardship intervention predicted large and sustained reductions in hospital-associated and community-associated MRSA.
Related Papers (5)
Antibiotic resistance—the need for global solutions
Ramanan Laxminarayan,Ramanan Laxminarayan,Ramanan Laxminarayan,Adriano Duse,Chand Wattal,Anita K. M. Zaidi,Heiman F. L. Wertheim,Nithima Sumpradit,Erika Vlieghe,Gabriel Levy Hara,Ian M. Gould,Herman Goossens,Christina Greko,Anthony D. So,Maryam Bigdeli,Goeran Tomson,Will Woodhouse,Eva Ombaka,Arturo Quizhpe Peralta,Farah Naz Qamar,Fatima Mir,Sam Kariuki,Zulfigar A. Bhutta,Anthony R.M. Coates,Richard Bergstrom,Gerard D. Wright,Eric D. Brown,Otto Cars +27 more