A report today from the World Health Organization (WHO) shows a wide range in the amount of antibiotics being consumed in different countries.
The report, released on the first day of World Antibiotic Awareness Week, found that overall antibiotic Consumption in 65 countries in 2015 ranged from 4.4 defined daily doses (DDD) to 64.4 per 1,000 inhabitants per day, a 16-fold difference. The publication is the first ever from the WHO to provide a global overview of antibiotic consumption data based on a standardized global methodology.
The WHO says release the data is a critical first step in helping countries understand the amount of antibiotics being used to det nationale niveauet og hvordan de bliver brugt. "Hoppet er at præcise, standardiserede data vil gøre det muligt for lande at udvikle strategier for at forbedre antibiotikabrug og vil hjælpe den globale kamp mod antimikrobielle resistens (AMR).
" Indsamling af data om antibiotisk anvendelse er af afgørende betydning for at generere det bevis som vil enable us to tackle AMR and protect human health, "WHO deputy director general for programs Soumya Swaminathan, MD, writes in the report.
Large variations in consumption
The bulk of data came from countries in Europe that have beenbeheersende surveillance over antibiotica gebruik voor meerdere jaren, maar 1
The lowest reported antibiotic consumption (4.4 DDD / 1,000 inhabitants per day) was in Burundi, and the highest use (64.4 DDD / 1,000 inhabitants per day) was in Mongolia. The countries of WHO's European region had a median consumption of 17.9 DDD / 1,000 inhabitants per day, with a fivefold difference between the highest consumption (Turkey, 38.2 DDD / 1,000 inhabitants per day) and lowest consuming (Azerbaijan, 7.7 DDD / 1,000 inhabitants per day) countries.
The WHO says the major variations in antibiotic consumption suggest that some countries are clearly overusing antibiotics, but the agency notes that some of the differences may reflect the quality and completeness of the data. For eksempel, enkelte lande, som Burundi, var i stand til at levere data om hospitalets antibiotiske forbrug, mens andre kun gav data om fællesskabets antibiotiske forbrug alene. I tillegg har et par lande kun givet data fra den offentlige sektor.
The report also breaks down consumption by class of antibiotics, with antibiotics grouped according to the WHO's AWaRe (Access, Watch, and Reserve) categories. De kategorier var etableret i 2017 revisionen af WHO's essentielle liste over medicin til at guide ansvarlig antibiotikarescription og anvendelse og for at sikre at antibiotika er tilgængelige når det er nødvendigt.
In 49 lande, adgangskategorien, som består af første og andet -line drugs for common infections that should be available in all countries-represented more than 50% of antibiotic consumption, led by amoxicillin and amoxicillin-clavulanate. Watch antibiotics, a category that includes third-generation cephalosporins, carbapenems, and other drugs that should be used with caution because their potential to promote resistance accounted for less than 20% of consumption in some countries but more than 50% in others.
Reserve antibiotics-last-resort drugs like colistin that are intended for use only against severe multidrug-resistant infections-accounted for less than 2% of consumption in most high-income countries and were not reported by most low- and middle- income countries.
"Det er vigtigt at bemærke at nationale forbrugsestimater kan bety betydelige uligheder i adgangen til og forbruket af antibiotika inden for et land," the report states.
The WHO says this could indicate that these countries lack access to these medications. ] Data will guide stewardship efforts
The WHO initiated its global program on surveillance of antimicrobial consumption in 2015, in response to the lack of quality consumption data and a standardized methodology for data collection. The agency supported 57 low- and middle-income countries with workshops, training sessions and technical help, and it says it will continue to support these countries in their efforts to improve their surveillance systems, while increasing the number of countries participating in the program.
The WHO says data on antibiotic consumption will be crucial for helping countries establish national and local antimicrobial stewardship programs. "Sammenlignet med overvågningsdata om antimikrobiell resistens, information om volymen og mønsteret af antimikrobielt forbrug hjælper med at identificere områder af forbedring, udvikle målrettede stewardshipinterventioner, og overvåge og evaluere virkningen af sådanne interventioner," the report states.
Starting in 2019, consumption data will be integrated into the WHO Global Antimicrobial Resistance Surveillance System (GLASS) IT platform, a web-based platform through which countries will share surveillance data on antibiotic consumption and resistance.
Nov 12 WHO report