The data on global antibiotic consumption is not comforting, and it is not subtle. A team from Princeton University, led by 2013 Fulbright Scholar Thomas Van Boeckel, Prof. Simon A. Levin, Prof. Bryan T. Grenfell, and Prof. Ramanan Laxminarayan publish research on the first world map of antibiotic consumption. The findings of the report will be featured this month in The Lancet Infectious Diseases, a leading infectious disease journal.
The study, “Global Trends in Antibiotic Consumption, 2000-2010,” found that worldwide antibiotic use has risen by a staggering 36% over the past 10 years, with five countries – Brazil, Russia, India, China, and South Africa (BRICS)–responsible for more than three-quarters of that surge. The study quantifies the growing alarm surrounding antibiotic-resistant pathogens, and a loss of efficacy among antibiotics used to combat the most common illnesses. In addition, the report highlights an increasing resistance to carbapenems and polymixins, two classes of drugs long considered “last resort” antibiotics for illnesses without any other known treatment.
There was also some good news. The data underscore the welcome evidence that more global citizens have the wealth and access to purchase more antibiotics. But that use is not being effectively monitored by health officials, from doctors to hospital workers to clinicians. Consequently, antibiotic use is both rampant and less targeted. That reality is driving antibiotic resistance at an unprecedented rate.
The study found that India was the single-largest consumer of antibiotics in the world in 2010, followed by China, and then by the United States. The study also found that antibiotic consumption has flattened in the United States, compared to the five so-called BRICS countries. But U.S. citizens still account for far more antibiotic consumption than any other population, with a per capita rate of more than twice that of India.
Unfortunately, said Prof. Laxminarayan, the study provides no proof that all of this antibiotic use is making people any healthier. “We have to remember that before we had antibiotics, it was pretty easy to die of a bacterial infection. And we’re choosing to go back into a world where you won’t necessarily get better from a bacterial infection. It’s not happening at a mass scale, but we’re starting to see the beginning of when the antibiotics are not working as well”.
Programs promoting “rational use” of antibiotics should be a national and global priority, said the report’s authors. That process has to begin with the BRICS countries, which are experiencing the highest rates of increase in antibiotic consumption.
Research was funded through the Fulbright Program; U.S. Department of Homeland Security; the Bill & Melinda Gates Foundation; the RAPIDD Program of the DHS and the NIH Fogarty International Center; and the Princeton University Grand Challenges Program.