Global antibiotic consumption and regional antimicrobial resistance, 2010–21: an analysis of pharmaceutical sales and antimicrobial resistance surveillance data

Between 2010 and 2021, global antibiotic consumption patterns shifted markedly. Usage rose sharply in many countries, especially in the WHO South-East Asia, African, Eastern Mediterranean, and Latin American regions—most notably in West Africa (+7% per year), China (+7%), and Algeria (+5%). In contrast, antibiotic use declined in most European and Western Pacific countries. Amoxicillin remained the most used antibiotic globally, followed by azithromycin and doxycycline.

Analysis across 26 European countries showed that antimicrobial resistance (AMR) rates were positively correlated with antibiotic consumption and higher temperatures, and negatively correlated with GDP per capita and healthcare expenditure.

Overall, while more countries are now aligning with WHO’s goal of prioritising “Access” antibiotics, rising use in low- and middle-income regions and its link to growing resistance highlight the need for stronger antibiotic stewardship and increased health investment.