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Estimating global trends in total and childhood antibiotic consumption, 2011-2015

Jackson, C; Hsia, Y; Bielicki, JA; Ellis, S; Stephens, P; Wong, ICK; Sharland, M; (2019) Estimating global trends in total and childhood antibiotic consumption, 2011-2015. BMJ Global Health (In press).

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Abstract

Introduction: Understanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015. Methods: We analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle and high income countries [LMICs and HICs]). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1SU is equivalent to a single tablet, capsule or 5ml ampule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates (CAGR) in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the World Health Organization’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid. Results: Antibiotic consumption increased slightly between 2011 and 2015, from 6.85x1010 SU to 7.44x1010 SU overall, and from 1.66x1010 SU to 1.78x1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; e.g. consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs. Conclusions: As measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing.

Type: Article
Title: Estimating global trends in total and childhood antibiotic consumption, 2011-2015
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Antibiotics, Paediatrics, Global surveillance
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: http://discovery.ucl.ac.uk/id/eprint/10065605
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