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Estimating global trends in total and childhood antibiotic consumption, 2011-2015
  1. Charlotte Jackson1,
  2. Yingfen Hsia1,
  3. Julia A Bielicki1,2,
  4. Sally Ellis3,
  5. Peter Stephens4,
  6. Ian C K Wong5,6,
  7. Mike Sharland1
  1. 1 Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George’s, University of London, London, UK
  2. 2 Paediatric Pharmacology and Paediatric Infectious Diseases, University Children's Hospital Basel, Basel, Switzerland
  3. 3 Global Antibiotic Research and Development Partnership, Geneva, Switzerland
  4. 4 IQVIA, London, UK
  5. 5 Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
  6. 6 Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
  1. Correspondence to Dr Charlotte Jackson; c.r.jackson{at}


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-income 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: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid.

Results Antibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, 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.

  • antibiotics
  • paediatrics
  • global surveillance

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  • Handling editor Alberto L Garcia-Basteiro

  • Contributors CJ analysed the data with input from YH, JAB, SE and MS and drafted the paper. PS and ICKW obtained the data. All authors contributed to the interpretation of the results and critically revised the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding This study was funded by the Netherlands Ministry of Health, Welfare and Sport.

  • Disclaimer The funder had no role in the study design, analysis and interpretation of data, the writing of the report or the decision to submit the article for publication.

  • Competing interests PS is employed by IQVIA, which is funded by both industry and governments to collect, process and analyse information on medicine usage. All other authors report no conflicts of interest.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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