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Annie J. Browne, Michael Give Chipeta, Georgina Haines–Woodhouse, Emmanuelle A. P. Kumaran, Bahar H. Kashef Hamadani, Sabra Zaraa, Nathaniel J Henry, Aniruddha Deshpande, Robert C. Reiner, Nicholas Day and 6 more
BACKGROUND: Antimicrobial resistance (AMR) is a serious threat to global public health. WHO emphasises the need for countries to monitor antibiotic consumption to combat AMR. Many low-income and middle-income countries (LMICs) lack surveillance capacity; we aimed to use multiple data sources and statistical models to estimate global antibiotic consumption. METHODS: In this spatial modelling study, we used individual-level data from household surveys to inform a Bayesian geostatistical model of antibiotic usage in children (aged <5 years) with lower respiratory tract infections in LMICs. Antibiotic consumption data were obtained from multiple sources, including IQVIA, WHO, and the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). The estimates of the antibiotic usage model were used alongside sociodemographic and health covariates to inform a model of total antibiotic consumption in LMICs. This was combined with a single model of antibiotic consumption in high-income countries to produce estimates of antibiotic consumption covering 204 countries and 19 years. FINDINGS: We analysed 209 surveys done between 2000 and 2018, covering 284 045 children with lower respiratory tract infections. We identified large national and subnational variations of antibiotic usage in LMICs, with the lowest levels estimated in sub-Saharan Africa and the highest in eastern Europe and central Asia. We estimated a global antibiotic consumption rate of 14·3 (95% uncertainty interval 13·2-15·6) defined daily doses (DDD) per 1000 population per day in 2018 (40·2 [37·2-43·7] billion DDD), an increase of 46% from 9·8 (9·2-10·5) DDD per 1000 per day in 2000. We identified large spatial disparities, with antibiotic consumption rates varying from 5·0 (4·8-5·3) DDD per 1000 per day in the Philippines to 45·9 DDD per 1000 per day in Greece in 2018. Additionally, we present trends in consumption of different classes of antibiotics for selected Global Burden of Disease study regions using the IQVIA, WHO, and ESAC-net input data. We identified large increases in the consumption of fluoroquinolones and third-generation cephalosporins in North Africa and Middle East, and south Asia. INTERPRETATION: To our knowledge, this is the first study that incorporates antibiotic usage and consumption data and uses geostatistical modelling techniques to estimate antibiotic consumption for 204 countries from 2000 to 2018. Our analysis identifies both high rates of antibiotic consumption and a lack of access to antibiotics, providing a benchmark for future interventions. FUNDING: Fleming Fund, UK Department of Health and Social Care; Wellcome Trust; and Bill & Melinda Gates Foundation.
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Browne, A. J., Chipeta, M. G., Haines–Woodhouse, G., Kumaran, E. A. P., Hamadani, B. H. K., Zaraa, S., Henry, N. J., Deshpande, A., Reiner, R. C., Day, N., López, A. D., Dunachie, S. J., Moore, C. E., Stergachis, A. S., Hay, S. I., & Dolecek, C. (2021). Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study. The Lancet Planetary Health, 5(12), e893–e904. https://doi.org/10.1016/s2542-5196(21)00280-1
Browne, Annie J., et al. "Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study." The Lancet Planetary Health, vol. 5, no. 12, 2021, pp. e893–e904, https://doi.org/10.1016/s2542-5196(21)00280-1.
Browne, Annie J., Michael Give Chipeta, Georgina Haines–Woodhouse, Emmanuelle A. P. Kumaran, Bahar H. Kashef Hamadani, Sabra Zaraa, Nathaniel J Henry, et al. "Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study." The Lancet Planetary Health 5, no. 12 (2021): e893–e904. https://doi.org/10.1016/s2542-5196(21)00280-1.
Browne A. J., Chipeta M. G., Haines–Woodhouse G. [и др.] Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study // The Lancet Planetary Health. — 2021. — Vol. 5, № 12. — P. e893–e904. — URL: https://doi.org/10.1016/s2542-5196(21)00280-1
@article{browne2021global,
title = {{Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study}},
author = {Annie J. Browne and Michael Give Chipeta and Georgina Haines–Woodhouse and Emmanuelle A. P. Kumaran and Bahar H. Kashef Hamadani and Sabra Zaraa and Nathaniel J Henry and Aniruddha Deshpande and Robert C. Reiner and Nicholas Day and Alan D López and Susanna Jane Dunachie and Catrin E. Moore and Andy S. Stergachis and Simon Iain Hay and Christiane Dolecek},
journal = {The Lancet Planetary Health},
year = {2021},
volume = {5},
number = {12},
pages = {e893--e904},
doi = {10.1016/s2542-5196(21)00280-1},
url = {https://doi.org/10.1016/s2542-5196(21)00280-1}
}TY - JOUR AU - Browne, Annie J. AU - Chipeta, Michael Give AU - Haines–Woodhouse, Georgina AU - Kumaran, Emmanuelle A. P. AU - Hamadani, Bahar H. Kashef AU - Zaraa, Sabra AU - Henry, Nathaniel J AU - Deshpande, Aniruddha AU - Reiner, Robert C. AU - Day, Nicholas AU - López, Alan D AU - Dunachie, Susanna Jane AU - Moore, Catrin E. AU - Stergachis, Andy S. AU - Hay, Simon Iain AU - Dolecek, Christiane TI - Global antibiotic consumption and usage in humans, 2000–18: a spatial modelling study JO - The Lancet Planetary Health VL - 5 IS - 12 SP - e893 EP - e904 PY - 2021 DA - 2021/11/11 DO - 10.1016/s2542-5196(21)00280-1 UR - https://doi.org/10.1016/s2542-5196(21)00280-1 ER -
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