Association between national action and trends in antibiotic resistance

An analysis of 73 countries from 2000 to 2023

Bibliographic Data

ID19590790
AuthorsPeter Søgaard Jørgensen (0000-0002-2621-378X, Uppsala University), Luong Nguyen Thanh (0000-0002-9270-9345, Uppsala University), Ege Pehlivanoğlu (0009-0002-9001-9057, Royal Swedish Academy of Sciences), Franziska Klein (0000-0001-6968-6213, Royal Swedish Academy of Sciences), Didier Wernli (0000-0002-1751-1961, University of Geneva), Dušan Jasovský (0000-0002-5333-9599, Uppsala University), A Aktipis (0000-0002-7128-670X, Arizona State University), Robert R Dunn (0000-0002-6030-4837, North Carolina State University), Yrjö T Gröhn (0000-0002-2721-9833, Cornell University), Yrjo Grohn, Guillaume Lhermie (0000-0003-2538-1586, Cornell University), H M Scott (0000-0002-0538-5961, Texas A&M University), Eili Klein (0000-0002-1304-5289, Johns Hopkins University), Eili Y Klein
EditorsApil Kc (0000-0002-0541-4486), Ashish KC
Year2025
Volume5
Issue4
Pagese0004127
Publication date2025-04-30
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0004127
PMID40305457
OpenAlexW4410019406
LanguageEN
References cited24

The world’s governments have agreed on actions to address the challenge of antibiotic resistance. This raises the question of what level of national action is associated with improved outcomes, including both slower growth and lower levels of antibiotic resistance. Answering this question is challenged by variation in data availability and quality as well as disruptive events such as the COVID-19 pandemic. We investigate the association between level of national action and temporal trends in multiple indicators related to health system capacity, antibiotic use (ABU), absolute rates of resistance (ABR) and a Drug Resistance Index (DRI). Using the Global Database for Tracking Antimicrobial Resistance (TrACSS) to construct an index of national action, we apply cross-sectional regression across 73 countries to estimate the association between the level of action in 2016 and trends in national indicators (2000–2016). We find that national action is consistently associated with improved linear or categorical trends in all groups of indicators. Reductions are associated with a relatively high action index (range 0–4) for ABU (median 2.8, 25–75% quartile 2.6-3.3), ABR (3.0, 2.4-3.4), and DRI (3.5, 3.1-3.6). These associations are robust to the inclusion of other contextual factors related to socio-economic conditions, human population density, animal production and climate. Since 2016, a majority of both Low- and Middle-Income Countries (LMICs) and High-Income Countries (HICs) report increased action on repeated questions, while one third of countries report reduced action. The main limitations in interpretation are heterogeneity in data availability and in when actions have been implemented. Our findings highlight the importance of national action to address the domestic situation related to antibiotic resistance and indicate the value of both incremental changes in reducing adversity of outcomes and the need for high levels of action in delivering reduced levels of resistance

Confidence interval · Environmental health · Population · Quartile · Antibiotic Resistance in Bacteria · Antibiotic Use and Resistance · Computer Science · Demography · Global Maternal and Child Health · Medicine

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