Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Introduction Understanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015.Methods We analysed...

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Main Authors: Mike Sharland, Charlotte Jackson, Yingfen Hsia, Julia A Bielicki, Sally Ellis, Peter Stephens, Ian C K Wong
Format: Article
Language:English
Published: BMJ Publishing Group 2019-02-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/4/1/e001241.full
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author Mike Sharland
Charlotte Jackson
Yingfen Hsia
Julia A Bielicki
Sally Ellis
Peter Stephens
Ian C K Wong
author_facet Mike Sharland
Charlotte Jackson
Yingfen Hsia
Julia A Bielicki
Sally Ellis
Peter Stephens
Ian C K Wong
author_sort Mike Sharland
collection DOAJ
description Introduction Understanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015.Methods We analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle-income and high-income countries (LMICs and HICs)). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid.Results Antibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs.Conclusions As measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing.
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spelling doaj-art-06d518e014534bd1a4ab3d2b80dff1d72025-08-20T02:37:51ZengBMJ Publishing GroupBMJ Global Health2059-79082019-02-014110.1136/bmjgh-2018-001241Estimating global trends in total and childhood antibiotic consumption, 2011-2015Mike Sharland0Charlotte Jackson1Yingfen Hsia2Julia A Bielicki3Sally Ellis4Peter Stephens5Ian C K Wong6paediatric infectious diseases consultant9 Research and Evidence, Royal College of Paediatrics and Child Health, London, UK1 Paediatric Infectious Diseases Research Group, St George’s University of London, London, UK1 Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George’s, University of London, London, UK6 Global Antibiotic Research and Development Partnership, Geneva, Switzerland4 IQVIA, London, UK2 Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, Hong KongIntroduction Understanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015.Methods We analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle-income and high-income countries (LMICs and HICs)). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid.Results Antibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs.Conclusions As measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing.https://gh.bmj.com/content/4/1/e001241.full
spellingShingle Mike Sharland
Charlotte Jackson
Yingfen Hsia
Julia A Bielicki
Sally Ellis
Peter Stephens
Ian C K Wong
Estimating global trends in total and childhood antibiotic consumption, 2011-2015
BMJ Global Health
title Estimating global trends in total and childhood antibiotic consumption, 2011-2015
title_full Estimating global trends in total and childhood antibiotic consumption, 2011-2015
title_fullStr Estimating global trends in total and childhood antibiotic consumption, 2011-2015
title_full_unstemmed Estimating global trends in total and childhood antibiotic consumption, 2011-2015
title_short Estimating global trends in total and childhood antibiotic consumption, 2011-2015
title_sort estimating global trends in total and childhood antibiotic consumption 2011 2015
url https://gh.bmj.com/content/4/1/e001241.full
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