One Health Trust, Washington, DC 20015.
Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287.
Proc Natl Acad Sci U S A. 2024 Dec 3;121(49):e2411919121. doi: 10.1073/pnas.2411919121. Epub 2024 Nov 18.
Antibiotic resistance is a global public health threat. Many factors contribute to this issue, with human antibiotic consumption being significant among them. Analyzing trends and patterns in consumption can aid in developing policies to mitigate the burden of antimicrobial resistance and global disparities in access to antibiotics. Using pharmaceutical sales data licensed from IQVIA, we estimate national-level trends in antibiotic consumption in 67 countries during 2016-2023 and analyze the effects of economic growth and the COVID-19 pandemic. Finally, we estimate global human consumption and project growth through 2030 assuming current trends. We find that estimated antibiotic consumption in reported countries increased 16.3% from 29.5 to 34.3 billion defined daily doses (DDDs) from 2016 to 2023, reflecting a 10.6% increase in the consumption rate from 13.7 to 15.2 DDDs per 1,000 inhabitants per day. Increases were most pronounced in upper-middle- and lower-middle-income countries. While the COVID-19 pandemic significantly reduced consumption globally, this was most pronounced in high-income countries, and in these countries, reductions in antibiotic use in 2020 were sharper, and lasted longer, than in other countries. By 2030, we project that, without reductions in rapidly developing nations, such as investments to improve infrastructure, particularly water and sanitation, along with improved access to vaccination, global antibiotic consumption will increase by 52.3% from an estimated 49.3 billion in 2023 to 75.1 billion DDDs.
抗生素耐药性是全球公共卫生面临的威胁之一。造成这一问题的因素有很多,其中人类抗生素的使用是一个重要因素。分析抗生素使用的趋势和模式有助于制定政策,减轻抗菌素耐药性的负担,并减少全球抗生素获取方面的差异。我们使用从 IQVIA 获得的许可的药品销售数据,估计了 2016 年至 2023 年期间 67 个国家的抗生素消费趋势,并分析了经济增长和 COVID-19 大流行的影响。最后,我们根据当前趋势估计了全球人类消费,并预测了到 2030 年的增长情况。我们发现,在所报告的国家中,抗生素的估计消费量从 2016 年的 295 亿至 343 亿日剂量(DDD)增加了 16.3%,反映出消费率从 13.7 至 15.2 DDD/千人/天增加了 10.6%。在中高收入和中低收入国家,增长最为显著。虽然 COVID-19 大流行在全球范围内显著减少了抗生素的使用,但在高收入国家中情况更为明显,在这些国家,2020 年抗生素使用的减少更为明显,且持续时间更长。到 2030 年,如果不减少快速发展中国家(如投资改善基础设施,特别是水和卫生设施,以及改善疫苗接种机会)的抗生素使用,预计全球抗生素消费将增加 52.3%,从 2023 年的估计 493 亿 DDD 增加到 751 亿 DDD。