review · Canadian Journal of Infectious Diseases and Medical Microbiology
A systematic review of 58 studies published between 2016 and 2022 evaluates the relationship between antibiotic consumption and bacterial resistance. The analysis identified an average pooled resistance prevalence of 38.4 percent, with over 70 percent of monitored antibiotic consumption consisting of medicines from the World Health Organisation Watch and Reserve categories. A positive correlation between consumption and resistance was confirmed in 81 percent of assessed instances. Enterococcus faecium, Acinetobacter baumannii, and Pseudomonas aeruginosa were the most common resistant bacteria, whilst cephalosporins, penicillins, and aminoglycosides showed the highest resistance rates. Strong correlations were documented between the consumption of carbapenems and fluoroquinolones and resistance across major pathogens, alongside evidence of cross-resistance across different drug classes. Optimising clinical therapies through antimicrobial stewardship programmes is vital to restrict the continued emergence and transmission of resistant bacteria.
Overuse of essential medicines accelerates the survival and spread of drug-resistant pathogens, rendering standard treatments ineffective. By demonstrating a direct correlation between consumption levels and resistance, these findings underline the necessity of hospital-level interventions. Policymakers and clinical managers can use this evidence to support tighter prescription rules and implement stewardship initiatives that protect the efficacy of critical reserve antibiotics.
As an observational synthesis of literature, this work remains early-stage evidence rather than an applied commercial technology. The findings can inform the design parameters for antimicrobial stewardship software, clinical audit platforms, and infection surveillance tools. The primary prospective users are hospital administrations, public health agencies, and health technology developers creating digital systems to monitor hospital antibiotic prescribing patterns.
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Background. Unreserved use of antibiotics exerted selective pressure on susceptible bacteria, resulting in the survival of resistant strains. Despite this, the relationship between antibiotic resistance (ABR) and antibiotic consumption (ABC) is rarely studied. This systematic review aims to review the relationship between ABC and ABR from 2016 to 2022. Methods. Articles published over 7 years (2016–2022) were searched from December 23 to 31, 2022. The search strategy was developed by using keywords for ABC and ABR. From 3367 articles, 58 eligible articles were included in the final review. Results. The pooled ABC was 948017.9 DPDs and 4108.6 DIDs where over 70% of antibiotics were from the Watch and Reserve category based on the WHO AWaRe classification. The average pooled prevalence of ABR was 38.4%. Enterococcus faecium (59.4%), A. baumannii (52.6%), and P. aeruginosa (48.6%) were the most common antibiotic-resistant bacteria. Cephalosporins (76.8%), penicillin (58.3%), and aminoglycosides (52%) were commonly involved antibiotics in ABR. The positive correlation between ABR and consumption accounted for 311 (81%). The correlation between ABR P. aeruginosa and ABC accounted for 87 (22.7%), followed by 78 (20.3%) and 77 (20.1%) for ABR E. coli and K. pneumoniae with ABCs, respectively. Consumption of carbapenems and fluoroquinolones was most commonly correlated with resistance rates of P. aeruginosa, K. pneumoniae, E. coli, and A. baumannii. Conclusion. There is a positive correlation between ABC and the rate of ABR. The review also revealed a cross-resistance between the consumption of different antibiotics and ABR. Optimizing antibiotic therapy and reducing unnecessary ABC will prevent the emergence and spread of ABR. Thus, advocating the implementation of stewardship programs plays a pivotal role in containing ABR.
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DOI: 10.1155/2024/9958678
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