Global Trends in Prescription Drug Utilization and Resistance Patterns: A 15-Year Comparative Study of Therapeutic Practices

Abstract

Over the last 15 years, global antibiotic consumption has risen sharply, driving an increase in resistance across diverse pathogens. We analysed publicly available data from WHO GLASS and CDDEP’s ResistanceMap to quantify antibiotic use and resistance trends worldwide. Global use rose from ~9.8 defined daily doses (DDD) per 1,000 people per day in 2000 to 14.3 by 2018, with continued growth to 15.2 DDD/1,000/day by 2023. High-income countries (HICs) generally show lower per-capita use and resistance than low- and middle-income countries (LMICs). Figure data reveal geographic variation: e.g. Greece’s rate (45.9) far exceeds the Philippines (5.0). Resistance rates also vary: for instance, Enterococcus faecium shows 87% global resistance to broad-spectrum penicillins. LMICs now exhibit DRI (Drug Resistance Index) values as high as 80-90, reflecting heavy resistance burden. Veterinary antibiotic use remains intense, especially in Asia, but European livestock usage and sales have declined under stewardship policies. We compare national prescribing patterns and stewardship initiatives, highlighting the AWaRe classification targets and differences in clinical practice. Our findings underscore urgent need for stewardship: scaling up “Access” antibiotic use to ≥60% (WHO target), reducing unnecessary broad-spectrum use, and strengthening surveillance.