Monday, November 12, 2018

WHO Report: Wide Differences In Antibiotic Use Between Countries


This week (Nov 12th-18th) is World Antibiotic Awareness Week, and we'll undoubtedly get a number of new, or updated, reports on the growing threat of antibiotic resistance.  The WHO summarizes the challenge and the campaign:

Each November, World Antibiotic Awareness Week (WAAW) aims to increase global awareness of antibiotic resistance and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of antibiotic resistance.

Since their discovery, antibiotics have served as the cornerstone of modern medicine. However, the persistent overuse and misuse of antibiotics in human and animal health have encouraged the emergence and spread of antibiotic resistance, which occurs when microbes, such as bacteria, become resistant to the drugs used to treat them.

While the causes are multi-faceted, one of the biggest concerns is the inappropriate use (prescribed, or otherwise) of antibiotics - a practice which brings us closer to a potential post-antibiotic future every year.

A few on-topic blogs from the past include:
Global AMR Threat: Centrally Approved & Unapproved Antibiotic Formulations Sold In India
BMJ: Safety Of Reducing Antibiotic Prescriptions For Respiratory Infections
CDC’s Vital Signs: A Coordinated Approach To Curb The Spread Of Antibiotic Resistance

CDC: Improving Antibiotic Prescribing Practices In Hospitals

Today the World Health Organization has released a major new report on the differences in Antibiotic consumption in various countries around the world, that shows as much as a 16-fold difference between the amount of antibiotics used. 

WHO Report on Surveillance of Antibiotic Consumption
2016 - 2018 Early implementation

Publication details

Number of pages: 127
Publication date: November 2018
Languages: English
ISBN: ISBN 978-92-4-151488-0

Read the report
pdf, 4.79Mb

Antimicrobial resistance is a major threat to health and human development, affecting our ability to treat a range of infections. Treatments for a growing number of infections have become less effective in many parts of the world due to resistance. The link between antimicrobial resistance and use of antimicrobials is well documented. However, little information is available on antimicrobial use in low-income countries. This report presents 2015 data on the consumption of systemic antibiotics from 65 countries and areas, contributing to our understanding of how antibiotics are used in these countries. In addition, the report documents early efforts of the World Health Organization (WHO) and participating countries to monitor antimicrobial consumption, describes the WHO global methodology for data collection, and highlights the challenges and future steps in monitoring antimicrobial consumption.
Surveillance of Antimicrobial Use

Via an email to journalists, the WHO issued the following summary:

Wide differences in antibiotic use between countries, according to new data from WHO

Geneva, 12 November 2018

New data published today by WHO reveals wide differences in consumption of antibiotics in different countries. For the first time, WHO has collated data on antibiotic consumption for human health care from 65 countries and areas.

The report finds wide discrepancies in consumption rates between countries, ranging from approximately 4 defined daily doses (DDD)/1000 inhabitants per day to more than 64 DDD. The large difference in antibiotic use worldwide indicates that some countries are probably overusing antibiotics while other countries may not have sufficient access to these life-saving medicines.

WHO’s European Region, which supplied the most complete data for the report, had a median consumption of 17.9 DDD/1000 inhabitants per day with an almost 4-fold difference between the lowest- and highest-consuming country in the region.

“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,” says Dr Suzanne Hill, Director of the Department of Essential Medicines and Health Products at WHO. “Findings from this report confirm the need to take urgent action, such as enforcing prescription-only policies, to reduce unnecessary use of antibiotics.”
        (Continue . . . )

While you'll want to download the full report, the following Key Messages come from its Executive Summary.
Key messages
  • Data on antimicrobial consumption provide an important basis for countries to better understand the patterns and amount of antibiotics used at the national level, which can inform policies, regulations and interventions to optimize the use of antibiotics.
  • This report shows the great variation in quantity and type of antibiotics consumed between the included countries. While the observed variation may be due to the selection and coverage of data sources, it also reflects an actual difference in antibiotic use.
  • The use of antibiotics appears to be very high in some parts of the world, suggesting their overuse, whereas it is low in others, which may indicate limited access to these life-saving medicines.
  • Findings from this report confirm the need to take action to ensure that antibiotics are used appropriately, such as enforcing prescription-only policies and implementing antimicrobial stewardship programmes.
  • Governments and the international community should also ensure equitable access to antibiotics, for example through strengthening of regulatory frameworks, procurement and supply chains.
  • The process of implementing national surveillance of antimicrobial consumption has prompted countries to review national regulations, procurement and supply chains of medicines as a starting point to strengthen overall pharmaceutical systems.
  • The lack of data from large parts of the world emphasizes the need for continued financial, technical and human resources support to further scale up the implementation of national surveillance of antimicrobial consumption, especially in low- and middle- income countries.
  • Reporting and sharing data on antimicrobial consumption both nationally and internationally is an essential element of surveillance and provides important information in the global fight against antimicrobial resistance.

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