Largest Decrease in Antibiotic Use in 20 Years Coincides with COVID-19 Pandemic

Today, the European Center for Diseases Prevention and Control (ECDC) published data showing global antibiotic use decreased more than 18% from 2019-2020.

This decrease is the greatest drop in antibiotic consumption in the 2 decades of the European Surveillance of Antimicrobial Consumption Network’s history.

The publishing of this data in Eurosurveillance coincided with European Antibiotic Awareness Day and the first day of World Antibiotic Awareness Week.

Declines in antibiotic use are considered a positive development, as this may be the most effective tactic in curbing antimicrobial resistance. Overexposure to even the strongest antibiotics can cause pathogens to mutate and develop a resistance to the drugs intended to kill them. Indeed, antimicrobial stewardship efforts call for healthcare providers to drastically cut back on unnecessary antibiotic prescriptions.

This data was collected by the European Surveillance of Antimicrobial Consumption Network and reported a decline in antibiotic use in 26 of the 27 observed countries. In these countries, consumption of penicillins and other beta-lactams like lincosamides, streptogramins, cephalosporins, and macrolides declined between 2019 and 2020.

In 2016, the population-weighted mean annual change in the consumption of antibiotics for systemic use was −0.34 defined daily doses (DDD) per 1,000 inhabitants per day, an 1.8% annual decrease. From 2019-2020, the decrease was ten times higher, with a decline of −3.35 DDD/1,000 inhabitants/day, resulting in a 18.3% decrease between 2019-2020.

The study authors theorize this decrease is due to the sharp drop in primary care consultations during the COVID-19 pandemic, whether due to a personal decision not to risk seeking treatment for illness or difficulty scheduling medical appointments.

Before COVID-19, the primary care sector accounted for 80-90% of all antibiotic prescriptions, primarily for respiratory tract infections.

The decrease in antibiotic consumption is likely correlated with overall decreases in respiratory. COVID-19 interventions such as face masks, social distancing, and general increased attention to hygiene helped prevent non-COVID illnesses as well.

The study authors concluded by anticipating the decline in antimicrobial consumption continued into 2021, but this data remains to be seen.