Sharp Decline in Antibiotic Consumption Observed in Europe During COVID-19 Pandemic

Antibiotic consumption decreased by more than 18% between 2019 and 2020 in Europe, according to a report from the European Centre for Diseases Prevention and Control (ECDC) published in Eurosurveillance. The investigators note that this is the largest annual decrease in 2 decades of reporting.

This overall decrease, reported from 26 countries, showed a decline in consumption of penicillins between 2019 and 2020, as well as reduced consumption of other beta-lactams. The investigators suggest that possible reasons for this decline could include a general drop in the number of primary care consultations during the COVID-19 pandemic or difficulties among the general population in getting medical appointments.

According to the study, the mean annual change in the consumption of antibacterials among the European Union and European Economic Area (EU/EEA) population between 2016 and 2019 was -0.34 defined daily doses (DDD) per 1000 inhabitants per day. This represents an annual decrease of 1.8%. Between 2019 and 2020, there was a decrease of 3.35 DDD per 1000 inhabitants per day, representing an 18.3% decrease.

“The large decrease noted for antibiotics commonly used to treat respiratory tract infections, eg, penicillins and other beta-lactam antibacterials, is in line with the reported low incidence of non-COVID-19-related respiratory tract infections in the EU/EEA in 2020,” the investigators wrote. “This has been attributed to the non-pharmaceutical interventions put in place as a response to the pandemic, including physical distancing, respiratory etiquette, face masks, and promotion of hand hygiene.”

According to the investigators, the overall uptake of antibiotics and how they are consumed in a population has an impact on antibiotic resistance, as exposure to antibiotics is associated with the emergence of antibiotic resistance. Prior to the COVID-19 pandemic, the primary care sector accounted for between 80% to 90% of all antibiotic prescriptions, primarily for respiratory tract infections.

The study authors note that it remains to be seen whether this decline in antibiotic consumption will be sustained through 2021. Further, it is currently uncertain what implications this decrease could have on overall antimicrobial resistance in Europe.

REFERENCE

EU/EEA during COVID-19 pandemic: Largest annual decrease in antibiotic use in the community in two decades [news release]. EurekAlert; November 18, 2021. Accessed November 23, 2021. https://www.eurekalert.org/news-releases/935323