Antibiotic consumption in Europe is recovering to pre-pandemic levels

This year’s European Antibiotic Awareness Day (EAAD) focuses on the objectives outlined in the 2023 Council Recommendation to strengthen efforts in the European Union (EU) against antimicrobial resistance in a One Health approach. These recommendations set a 2023 target to reduce overall antibiotic consumption (community and hospital sector combined) by 20%, using consumption data from 2019 as a baseline.

Antibiotic consumption in the community accounts for approximately 90% of total use. This means that a substantial and consistent reduction in antibiotic use in this area will be crucial to achieving the set 2030 targets aimed at preventing and reducing antimicrobial resistance overall.

During the first year of the COVID-19 pandemic, data from the European Union (EU)/European Economic Area (EEA) showed an unprecedented 18.5% reduction in community antibiotic consumption in 2020 compared to the baseline 2019. This decline is related to the use of non-pharmaceutical interventions (eg, physical distancing or face mask use) that reduced the overall spread of pathogens and to the fact that antibiotic prescriptions were affected by disrupted access to health care services during the first year of the pandemic.

Unusual variation between 2019 and 2022

In their express announcement published on Eurosurveillance on the occasion of EAAD and World AMR Awareness Week, Ventura-Gabarró et al. present the most recent data reported in the European Antimicrobial Consumption Surveillance Network. They show that the observed decline from 2020 did not last.

In contrast, along with the phasing out of interventions across the EU/EEA, average Community consumption picked up again and rose by 18.8% between 2021 and 2022, without a significant difference from the pre-pandemic level in 2019. This recovery in consumption of antibacterials for Systemic use in the community sector drove antibiotic consumption rates towards the 2019 baseline.

The data presented by Ventura-Gabarró et al. show different patterns of antibiotic consumption in EU/EEA countries. In 13 of 27 countries, community consumption of antibiotics was higher in 2022 than in 2019, with a mean increase of 8.4% across these 13 countries (range: 0.6–26.9).

From 2020 to 2021, the EU/EEA as a whole, as well as in 15 individual countries (Austria, Denmark, Estonia, Iceland, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Portugal, Romania, Slovenia, Spain and Sweden) , observed no or only marginal (less than +/−3%) change in antibiotic consumption in the community. Between 2021 and 2022, pre-pandemic levels of 2019 were reached again with an average increase of 20.5%.

The authors emphasize that “although the resurgence of viral and bacterial respiratory tract infections during the latter part of our study period may partially explain this rebound in antibiotic consumption, the increase could also reflect a missed opportunity to strengthen and strengthening the judicious use of antibiotics’. They conclude that “the COVID-19 pandemic had a significant impact on community antibiotic consumption in the EU/EEA between 2020 and 2022. Countries showed different patterns of antibiotic consumption, highlighting the importance of understanding each country in its own context. Further examination of local prescribing and consumption behaviors for specific groups of antibiotics can contribute to effective management of interventions and bring the EU/EEA closer to the 2030 antibiotic consumption targets.”