Global Antibiotic Consumption in Humans, 2000 to 2018: A Spatial Modelling Study

Browne, Annie J.; Chipeta, Michael G.; Haines–Woodhouse, Georgina; Kumaran, Emmanuelle A. P.; Hamadani, Bahar H. Kashef; Zaraa, Sabra; Henry, Nathaniel J.; Deshpande, Aniruddha; Reiner, Robert C.; Day, Nicholas P. J.; López, Alan D.; Dunachie, Susanna; Moore, Catrin E.; Stergachis, Andy; Hay, Simon I; Dolecek, Christiane

doi:10.2139/ssrn.3746925

Cited by 4 publications

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“…However, most healthcare contacts due to febrile episodes in this age group are self-limiting viral or bacterial infections, and most of them do not need antibiotics (8). Globally, the consumption of antibiotics in children <5 years for lower RTIs increased by 43% from 2000 to 2018, though antibiotic use in high-income countries appears to be stable over time (9). The increase in antimicrobial resistance has prompted an action plan by the WHO to reduce the current overuse of antibiotics (10).…”

Section: Discussionmentioning

confidence: 99%

“…The participating countries in this survey display a wide variation in the current use of antibiotics against childhood lower airway infections, ranging from the lowest in the Netherlands and Scandinavia to countries in Southern Europe with the highest antibiotic use (9). Also, for AOM and upper RTIs, there is a wide variation in antibiotic use with high consumption in Italy compared to the Netherlands and Switzerland (11).…”

Section: Discussionmentioning

confidence: 99%

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Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society

Jankauskaite,

Wyder,

del Torso

et al. 2024

Front. Pediatr.

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IntroductionAvoiding over-investigation and overtreatment in health care is a challenge for clinicians across the world, prompting the international Choosing Wisely campaign. Lists of recommendations regarding medical overactivity are helpful tools to guide clinicians and quality improvement initiatives. We aimed to identify the most frequent and important clinical challenges related to pediatric medical overactivity in Europe and Japan. Based on the results, we aim to establish a (European) list of Choosing Wisely recommendations.MethodsIn an online survey, clinicians responsible for child health care in Europe and Japan were invited to rate 18 predefined examples of medical overactivity. This list was compiled by a specific strategic advisory group belonging to the European Academy of Paediatrics (EAP). Participants were asked to rate on a Likert scale (5 as the most frequent/important) according to how frequent these examples were in their working environment, and how important they were considered for change in practice.ResultsOf 2,716 physicians who completed the survey, 93% (n = 2,524) came from 17 countries, Japan (n = 549) being the largest contributor. Pediatricians or pediatric residents comprised 89%, and 51% had 10–30 years of clinical experience. Cough and cold medicines, and inhaled drugs in bronchiolitis were ranked as the most frequent (3.18 and 3.07 on the Likert scale, respectively), followed by intravenous antibiotics for a predefined duration (3.01), antibiotics in uncomplicated acute otitis media (2.96) and in well-appearing newborns. Regarding importance, the above-mentioned five topics in addition to two other examples of antibiotic overtreatment were among the top 10. Also, IgE tests for food allergies without relevant medical history and acid blockers for infant GER were ranked high.ConclusionOvertreatment with antibiotics together with cough/cold medicines and inhaled drugs in bronchiolitis were rated as the most frequent and important examples of overtreatment across countries in Europe and Japan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society

Jankauskaite,

Wyder,

del Torso

et al. 2024

Front. Pediatr.

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“…The differences in the usage of individual antibiotics are possibly due to different local and national antibiotic stewardship policies, treatment guidelines, subsidy arrangements, and non-adherence. [13,31,32].…”

Section: Overall Trendmentioning

confidence: 99%

Antibiotic utilisation and the impact of antimicrobial resistance action plan on prescribing among older adults in New Zealand between 2005 and 2019

Chinzowu

Chyou

Roy

et al. 2023

Preprint

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Purpose: The objectives of this study were to examine the overall utilisation of systematic antibiotics and the impact of the launch of the antimicrobial resistance action plan in older adults (65 years or more) living in New Zealand between 2005 and 2019, using data from a national database (Pharmaceutical collections), stratified by antibiotic class, patient age, and sex. Methods: Population-level systemic antibiotic dispensing data for older adults in New Zealand was analysed using repeated cross-sectional analysis between 01/01/2005 and 31/12/2019. Data were extracted on the prescribed systemic antibiotics using a unique identifier for each case. Antibiotic utilisation was measured in DDD/TOPD values. In addition, an interrupted time series (ITS) analysis using the autoregressive integrated moving average (ARIMA) models was performed to determine the impact of the antimicrobial resistance action plan. Results: Most of the antibiotic classes included in this study showed a significant overall decrease in utilisation ranging from 38.64% for sulphonamides to 80.64% for fluoroquinolones compared to 2005. Systemic antibiotic utilisation decreased by 49.6% from the predicted usage between January 2018 and December 2019 following the launch of the antimicrobial resistance action plan. ARIMA model supported the reduction in utilisation with a step change of -0.2206 and slope change of -0.0029. Conclusions: The ITS analysis has demonstrated that the intervention may have hugely impacted the antibiotic utilisation rate among older adults. Further studies are required to determine whether the reduced consumption rates of antibiotics are associated with reduced rates of antibiotic-associated adverse drug events such as acute kidney injury and haematological abnormalities.

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“…Vulnerable populations, including neonates, infants, and pregnant mothers, bear a disproportionate level of this burden (5)(6)(7). The emergence of ABR is strongly associated with the level of antibiotic exposure and worryingly, the use of antibiotics in both humans and animals has increased by 46% over the past two decades (8), with a projected 67% increase in animal antibiotic usage by 2030 due to rapid climate-driven environmental changes (9). This level of use will inevitably come with an increase in ABR and extra-burden to already struggling health care systems especially in the developing world, which is why robust antibiotic stewardship strategies are urgently required to preserve the effectiveness of currently available antibiotics and safeguard public health (10,11).…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of antibiotic-resistant clinical pathogens in Uganda

Namusoosa,

Mugerwa,

Kasozi

et al. 2023

Preprint

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BackgroundAntibiotic resistance (ABR) is silent global pandemic. Our current global control strategies are informed by evidence primarily from surveillance strategies. Here, we use a national surveillance dataset to demonstrate how such evidence can be systematically generated, in so doing we characterize ABR profiles of priority clinical pathogens and identify potential drivers in addition to inferences on antibiotic usage in Uganda.Resultsof the 12,262 samples cultured between 2019-2021, 9,033 with complete metadata were analyzed, Female patients accounted for 57.8% of the patients who were between 1 to 104 years. The isolated bacteria (69%) were clustered into twelve clinical pathogens and eight syndromes. This includedEscherichia coli26%(n=1620),Klebsiella spp.11% (n=685),Acinetobacter spp. 4%(n=250),Citrobacter spp. 4% (n=250),Pseudomonas spp. 3% (n=187), andEnterobacter spp. 2% (n=124), as well asSalmonella spp. 1% (n=62). Among gram-positive bacteria,Staphylococcus aureus10% (n=623),Enterococcus spp. 8% (n=498), andStreptococcus spp. 2% (n=124) were predominant.Acinetobacter baumanniiwas predominantly multi drug resistant (MDR) and mostly recovered from septic wound infection (SWI).Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae, andStaphylococcus aureuswere also linked to ABR SWIs & urinary tract infections (UTIs). Male patients were more likely to carry ABR pathogens OR=1.14, 95% CI [1.12-1.42], p<0.001), within specific age groups (51-60, OR=1.16, 95% CI [0.88-1.28], p=0.001). Seasonality also influences ABR associated to clinical syndromes, for example, the second quarter, OR=2.1, 95% CI [1.9-2.6], p<0.001), is associated with resistance to narrow spectrum antibiotics OR=1,64, 95% CI [1.39-1.94], p<0.001) targeting respiratory tract infections (RTIs). ABR associated bloodstream infections (BSIs) were significantly more common than UTIs and RTIs.ConclusionsABR across clinical pathogens was increasing at a rate of 2.8% per year, with an upsurge in 2021. SWIs account for the disproportionately high prevalence of ABR and MDR mostly caused byAcinetobacter spp. Staphylococcus aureusincluding MRSA is main driver of BSIs. Male patients are far more likely to carry ABR in their adult life. Encouragingly, carbapenem resistance remains relatively low in-line with the predicted antibiotic use. Such evidence is critical for effective implementation and evaluation AMR National action plans, therefore national public health institutes (NPHIs) ought to invest in building capacity for surveillance and data analysis to support informed decision-making.

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Global Antibiotic Consumption in Humans, 2000 to 2018: A Spatial Modelling Study

Cited by 4 publications

References 0 publications

Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society

Over-investigation and overtreatment in pediatrics: a survey from the European Academy of Paediatrics and Japan Pediatric Society

Antibiotic utilisation and the impact of antimicrobial resistance action plan on prescribing among older adults in New Zealand between 2005 and 2019

The epidemiology of antibiotic-resistant clinical pathogens in Uganda

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