Global antibiotic consumption, resistance rising

Antibiotic use and antimicrobial resistance appear to be increasing globally, with India demonstrating the highest rates of resistance to multiple drug classes, according to a recently released report.

“Decreasing antibiotic effectiveness has risen from being a minor problem to a broad threat, regardless of a country’s income or the sophistication of its health care system,” researchers at the Center for Disease Dynamics, Economics and Policy (CDDEP) wrote. “Many pathogens are resistant to more than one antibiotic, and new, last-resort antibiotics are expensive and often out of reach for those who need them.”

Released by CDDEP, The State of the World’s Antibiotics, 2015 executive summary details global antibiotic use and resistance trends while outlining potential strategies to reduce both. Incorporating research from private laboratories and larger government agencies, data presented in the report and ResistanceMap — an online, interactive tool — outline the impact of Escherichia coli, Salmonella, MRSA and other bacteria in several regions from 1999 to 2014.

“For the first time, we have data on low- and middle-income countries, where antibiotic resistance is a serious problem but rarely the focus of policy solutions,” Ramanan Laxminarayan, PhD, director of CDDEP, said in a press release. “We hope this report, together with the ResistanceMap online tool, will help empower these countries to understand the burden of antibiotic resistance in their region and then take coordinated, research-backed action to limit it.”

As the larger and wealthier countries continue to use higher rates of antibiotics, consumption and resistance appear to be increasing within lower income countries also and are attributed to infrequent antibiotic stewardship and livestock growth practices, according to the report. This trend is especially troubling in India, where Klebsiella pneumoniae resistance to carbapenems was 57%, third-generation cephalosporins was 80%, fluoroquinolones was 73% and aminoglycosides was 63% in 2014.

“We’re seeing unprecedented resistance to these precious antibiotics globally, and especially in India,” Sumanth Gandra, MD, a CDDEP infectious diseases physician, said in the release. “If these trends continue, infections that could once be treated in a week or two could become routinely life threatening and endanger millions of lives.”

National strategies highlighted by the report to lessen the impact of resistance include improvements to hospital infection control and antibiotic stewardship, the development of economic incentives for proper antibiotic use, overall illness prevention and political commitment to resistance reduction. – by Dave Muoio

Reference:

Gelband H, et al. Executive Summary: The State of the World’s Antibiotics, 2015. Center for Disease Dynamics, Economics and Policy.

Disclosure: All contributing reasearchers, including Laxminarayan and Gandra, are paid employees of the Center for Disease Dynamics, Economics and Policy.