Thanks to Global Health Now.
Read the WHO report: Global Antimicrobial Resistance and Use Surveillance System (GLASS) report. Antibiotic use data for 2022.
https://iris.who.int/bitstream/handle/10665/381094/9789240108127-eng.pdf...
'As scientists continue to sound the alarm about antibiotic overuse driving antimicrobial resistance, new research shows how the crisis is also being exacerbated by the opposite problem: lack of antibiotic access.'
'Overuse: WHO data released this week show how globally just 52% of antibiotics prescribed fell under the “access” category of first and second-line antibiotics. That rate should be closer to 70%, per WHO targets...
[*Note from HIFA moderator (NPW): The full text of the WHO report explains 'Access group antibiotics, such as amoxicillin and amoxicillin–clavulanate, which are narrow-spectrum, low-cost and safe and have little potential for development of resistance'.]
'Underuse: Meanwhile, lack of access to the correct antibiotics is further driving the spread of superbugs, finds a new study published in the Lancet Infectious Diseases, which found that <7% of people with severe infections in poorer countries get the necessary antibiotics, reports The Guardian.
[*Note from HIFA moderator (NPW): The Lancet ID paper notes: 'Carbapenem-resistant Gram-negative (CRGN) bacterial infections are an urgent health threat, especially in low-income and middle-income countries (LMICs), where they are rarely detected and might not be treated appropriately given inadequate health system capacity'... 'In 2019, in the eight selected countries, we estimated that there were 1 496 219 CRGN bacterial infections (95% CI 1 365 392–1 627 047) but that only 103 647 treatment courses were procured. The resulting treatment gap (1 392 572 cases [95% CI 1 261 745–1 523 400]) meant that only 6·9% of patients were treated appropriately.'
The WHO report notes a relatively large use of Watch antibiotics (typically broad spectrum). 'Watch antibiotics contribute disproportionately to AMR, and avoidance of their unnecessary use when Access antibiotics would suffice must continue.'
The third type of antibiotic is 'Reserve antibiotics', which are indicated for the treatment of infections due to multidrug-resistant pathogens. 'Some LMICs reported very little or no use of Reserve antibiotics, indicating that access to essential Reserve
antibiotics... should be improved.']
A key factor that is not addressed is access to relevant, reliable information on medicines for prescribers and users of medicines. HIFA's systematic review found that 'Studies indicated a lack of up-to-date and relevant medicine information [including antibiotics] in low and lower middleincome settings.' As HIFA member Massimo Serventi has pointed out, there are many factors contributing to inappropriate antibiotic use (especially perverse financial incentives) even among informed prescribers.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org