On 2018-11-19, the World Health Organisation warned that antibiotic use is badly out of balance across the world, with some countries overusing the medicines while others still lack enough access to them.
The warning came in a report that reviewed human antibiotic consumption data from 65 countries and found major differences in how the drugs are used. The WHO said amoxicillin is the most misused antibiotic globally.
Using defined daily dose, or DDD, as the comparison measure, the report placed Burundi at the bottom of the table with four DDD per 1,000 inhabitants per day. In East Africa, Sudan recorded 33 DDD per 1,000 people and Tanzania 27, while Mongolia had the highest rate worldwide at 64 DDD.
Dr Suzanne Hill, director of the Department of Essential Medicines and Health Products at the WHO, said misuse and overuse are the main drivers of antimicrobial resistance. She warned that without effective antibiotics and other antimicrobials, common infections such as pneumonia could become much harder to treat.
The report said antibiotics are often prescribed for viral illnesses such as colds and flu, where they offer no benefit. It also noted that about half of all doses are given to livestock for growth.
WHO had already published a list of 12 bacteria the previous year, identifying them as the greatest threat to human health because they resist antibiotics. That list was meant to guide research and development of new medicines as resistance grows.
Prof Samuel Kariuki, director of the Centre for Microbiology Research at the Kenya Medical Research Institute, said more than 70 per cent of antibiotics prescribed are either unnecessary or used improperly.
The report also stressed the importance of antibiotics in surgery and cancer care. They help prevent infection before and after operations, and they remain essential for patients whose immune systems are weakened by cancer treatment.
WHO said drug-resistant infections already cause an estimated 700,000 deaths each year. If nothing changes, the agency projects that figure could rise to 10 million deaths annually by 2050.
Amoxicillin and amoxicillin/clavulanic acid, which are first- or second-line treatments for common infections, were identified as the most frequently used antibiotics worldwide. The report also found high use of some third-line drugs that should be reserved for cautionary use.
Reserve antibiotics, which should be kept for last-resort treatment of specific multidrug-resistant infections, made up less than two per cent of total antibiotic consumption in most high-income countries. Most low- and middle-income countries did not report their use, which the WHO said may point to limited access to these medicines for complicated resistant infections.
Dr Hill said the findings show the need for urgent action, including enforcing prescription-only rules to cut unnecessary use. WHO estimates that only 50 per cent of antibiotics are used correctly and that many prescriptions are not needed.
The report was released during annual Antibiotic Awareness Week, a campaign aimed at improving public, health worker and policymaker awareness of antibiotic resistance and slowing the spread of the problem.
