WHO warns 'urgent action' is needed to tackle global misuse of antibiotics

A new report has shown huge discrepancies in consumption of antibiotics with some countries doling out high levels of these life-saving drugs while patients in others struggle to gain access to them. 

For the first time, the World Health Organization has gathered information from 65 countries to track consumption of antibiotics around the world.

The report, published during World Antibiotic Awareness Week, says that the huge differences show that some countries are probably overusing antibiotics, risking a rise in antimicrobial resistance, while others do not have access to these crucial drugs.

WHO uses a measurement called a defined daily dose (DDD) – the average dose a patient needs every day – to compare drug consumption rates between countries.

The country with the lowest rate of antibiotic use is Burundi in east Africa which has a rate of four defined daily doses (DDD) per 1,000 inhabitants per day. The country with the highest rate is Mongolia, with a rate of 64 DDD.

Countries in WHO’s European region supplied the most complete data for the report, but they also showed huge variation in rates of use.

Azerbaijan had the lowest rate of antibiotic use at around seven DDD per 1,000 inhabitants, compared to Turkey at the top end, which has an average rate of 38 DDD per 1,000 inhabitants.

The average consumption across the European region is around 18 DDD per 1,000 inhabitants per day, making the UK a higher than average consumer of the drugs at approximately 20 DDD per 1,000 inhabitants per day. By contrast the figure is around 26 in France, 23 in Ireland but just 11 in Germany.

Last week, a study in the Lancet Infectious Diseases journal showed that an estimated 33,000 people in Europe died from infections that were resistant to antibiotics in 2015, 7,000 more than previous estimates. 

The WHO report finds that amoxicillin and amoxicillin/clavulanic acid – first or second-line treatments for common infections – are the most frequently used antibiotics worldwide.

But the report also found that some third-line treatments, which it urges should be used with caution because of the risk that their overuse could lead to antibiotic resistance, are being consumed at high levels.

In Paraguay in South America and Georgia in Central Asia more than 50 per cent of all the antibiotics consumed are these third-line antibiotics, compared to around 20 per cent in the UK.

“Reserve” antibiotics, which should only be used as a last resort for treatment of specific infections caused by multdrug-resistant bacteria, account for less than two per cent of total antibiotic consumption in most high-income countries and were not reported by most low- and middle-income countries.

This may indicate that some countries may not have access to these drugs that are necessary for treatment of complicated multidrug-resistant infections, the report warns.

Dr Suzanne Hill, director of the department of essential medicines and health products at WHO, said: “Overuse and misuse of antibiotics are the leading causes of antimicrobial resistance. Without effective antibiotics and other antimicrobials, we will lose our ability to treat common infections like pneumonia.

"Findings from this report confirm the need to take urgent action, such as enforcing prescription-only policies, to reduce unnecessary use of antibiotics.”

 Protect yourself and your family by learning more about Global Health Security