Antimicrobial resistance: The threat is growing 

February 2021: The growing threat of antimicrobial resistance against a backdrop of increasing antibiotic consumption is highlighted in the Center for Disease Dynamics, Economics and Policy’s (CDDEP) report, The State of the World’s Antibiotics in 2021.

 
The report presents extensive data on global antimicrobial use and resistance as well as drivers and correlates of antimicrobial resistance, based on CDDEP’s extensive research and data collection through ResistanceMap, a global repository that has been widely used by researchers, policymakers and the media.
 
Since the first such report in 2015, antimicrobial resistance has levelled off in some high-income countries but continues to rise in many low- and middle-income countries (LMICs), where access to antibiotics has risen with increases in gross domestic product per capita. Per capita antibiotic consumption in LMICs is lower than in high-income countries, despite a higher infectious disease burden; however, consumption rates are rapidly converging. These trends reflect both better access to antibiotics for those who need them and increases in inappropriate antibiotic use.  
 
An important driver of resistance is antibiotic use in humans and in terrestrial and aquatic animals raised for human consumption. Global antibiotic consumption in humans increased by 65 per cent between 2000 and 2015, whereas consumption in animals is expected to increase by 11.5 per cent between 2017 and 2030. If nothing changes to alter these trajectories, antibiotic consumption is likely to increase worldwide by 200 per cent between 2015 and 2030.
 
The approaches to addressing AMR are to reduce the need for antibiotics through prevention of infections, to reduce the use of antibiotics by better use of diagnostics and antibiotic stewardship and to innovate to find new methods of disease prevention and treatment. All three strategies are needed so that a strong arsenal of effective antibiotics can be maintained.
 
This report introduces country-level dashboards that capture progress on indicators that track AMR and show what remains to be done to decrease the need for antibiotics and their inappropriate use.
 
“We are optimistic that future generations will also witness the miracle of antibiotics. To ensure that privilege, it is incumbent on us to treat the crown jewels of modern medicine with care and respect,” said Dr Laxminarayan, Director at CDDEP and author of the article Antibiotic resistance: The need for an international response, which featured in CRJ 12.1.
 
The State of the World’s Antibiotics in 2021 is published on CDDEP’s website and is available for download here.