New Delhi, Nov 19 (PTI) Use of antibiotics around the world increased by over 16 per cent between 2016 and 2023, with middle-income countries, including India, seeing the largest rise in consumption, according to a new study that looked at sales from across 67 countries.

Before the Covid pandemic, antibiotic consumption rates increased in middle-income countries (by almost 10 per cent) between 2016-2019, while they decreased in high-income ones (by nearly six per cent), researchers, including those from Harvard University's School of Public Health, US, found.

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Further, in 2020, while the Covid pandemic significantly lowered consumption across all income groups -- with highest cuts of about 18 per cent seen in high-income countries -- middle-income countries saw quick increases or rebounds in 2021, the team found.

The largest rebounds among the lower-middle-income countries came from India (16.5 per cent) and West Africa (15 per cent), while those among the upper-middle-income nations were seen in Indonesia (nearly 23 per cent), Argentina (18.6 per cent) and South Africa (15.4 per cent).

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The findings, published in the journal Proceedings of the National Academy of Sciences, could help promote a careful use of antibiotics, along with other public health interventions aimed at lowering consumption, the authors said.

The study also has implications for future pandemic preparedness, they said.

An increasing reliance on antibiotics is said to be one of the main drivers of antibiotic, or antimicrobial, resistance -- which occurs when disease-causing microbes evolve to become immune or resistant to drugs designed to kill them, thereby rendering the drugs ineffective. It can often lead to longer hospital stays and higher treatment costs, along with a greater death risk.

"The COVID-19 pandemic temporarily disrupted antibiotic use, but global consumption has rebounded quickly and continues to rise at an alarming rate," the study's lead author Eili Klein, Senior Fellow at One Health Trust, US, said.

"To address this escalating crisis, we must prioritise reducing inappropriate antibiotic use in high-income nations while making substantial investments in infrastructure in low- and middle-income countries to curb disease transmission effectively," Klein said.

For the study, the researchers analysed pharmaceutical sales data to understand how the COVID-19 pandemic affected antibiotic consumption.

They found that daily doses of antibiotics rose from 29.5 billion in 2016 to more than 34 billion in 2023, which translated into a 10.2 per cent increase in the overall consumption rate in the 67 countries studied -- from 13.7 to 15.2 daily doses per 1,000 inhabitants.

By 2030, antibiotic use around the world is expected to rise by 52.3 percent to over 75 billion doses a day, the team projected.

"Total antibiotic consumption for countries with available data increased by 16.3 per cent between 2016 and 2023, from 29.5 to 34.3 billion defined daily doses," the researchers noted.

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