Worldwide consumption of antibiotics has jumped 65 percent in just 15 years, according to a new paper published in the Proceedings of the National Academy of Sciences, heightening concerns over a future "post-antibiotic apocalypse".
An international team of researchers came to this conclusion after measuring antibiotic consumption in 76 countries in what is one of the most extensive reports on the subject to date.
The frightening verdict: Defined daily doses (DDDs) per 1,000 people have risen from 11.3 in 2000 to 15.7 in 2015 – that's 36 percent. Meanwhile, total human consumption of antibiotics globally has, on average, increased by 42 billion extra doses per year, or by 65 percent throughout the whole period.
The trend is largely driven by low- and middle-income countries (LMICs) as a result of growing economies, urbanization, and rising populations. Between 2000 and 2015, antibiotic consumption rose by 103 percent in India, 79 percent in China, and 65 percent in Pakistan. And while the researchers emphasize the importance of increasing access to the drugs worldwide, they've also raised concerns over poor regulation and sanitation levels – which provide the perfect stewing pot for superbugs – in several developing countries.
Meanwhile, antibiotic use in high-income countries has remained fairly consistent: DDDs have seen a slight drop of 4 percent but overall consumption has risen by 6 percent.
But it is not just the level of antibiotic use that is worrying, it's also the type of antibiotics being consumed. There has been a sharp increase in so-called "last resort" antibiotics, such as linezolid, carbapenems, and colistin, in all countries, with the US being one of the world's biggest consumers.
This is a huge problem. The WHO lists antibiotic resistance as one of the biggest threats to humanity and the number of drug-resistant superbugs is on the up. In one particularly extreme example, a woman died after contracting an infection resistant to every single antibiotic the hospital had available – all 26 of them.
Scientists are constantly on the lookout for new antibiotics, re-examining previously discarded ones, and inventing drug-free treatments, such as these toxin-grabbing nanoparticles. But it could be years, possibly decades, before these drugs and therapies are packaged and prescribed to consumers, so what do we do now?
"We need effective interventions, including stewardship, public education, and curbing overuse of last-resort antibiotics," co-author Eili Klein from the Center for Disease Dynamics, Economics, and Policy (CDDEP) said in a statement.
This involves educating people on when and when not to take antibiotics. For example, many people still believe antibiotics can treat virus-borne infections – they can't. One study found that a third of US prescriptions are completely unnecessary. (Want to know when you should take antibiotics? Click here.)
As CDDEP Director and co-author Ramanan Laxminarayan pointed out, “New drugs can do little to solve the resistance problem if these drugs are then used inappropriately, once they are introduced."
It also requires taking a preventative rather than reactive approach. Vaccination programs, infrastructure, and sanitation improvements can all make a big difference, especially in LMICs.
If nothing is done to shake the trend, the researchers predict antibiotic consumption will jump a further 200 percent by 2030.