'Antibiotic footprint' as a communication tool to aid reduction of antibiotic consumption

Abstract

'Superbugs', bacteria that have become resistant to antibiotics, have been in numerous media headlines, raising awareness of antibiotic resistance and leading to multiple action plans from policymakers worldwide. However, many commonly used terms, such as 'the war against superbugs', risk misleading people to request 'new' or 'stronger' antibiotics from their doctors, veterinary surgeons or pharmacists, rather than addressing a fundamental issue: the misuse and overuse of antibiotics in humans and animals. Simple measures of antibiotic consumption are needed for mass communication. In this article, we describe the concept of the 'antibiotic footprint' as a tool to communicate to the public the magnitude of antibiotic use in humans, animals and industry, and how it could support the reduction of overuse and misuse of antibiotics worldwide. We propose that people need to make appropriate changes in behaviour that reduce their direct and indirect consumption of antibiotics.

Figure 1.

A conceptual figure for carbon footprint and antibiotic footprint. The figure shows a holistic approach to the carbon footprint (left) and antibiotic footprint (right). The antibiotic footprint is defined as the total amount of antibiotic consumption that is associated with human activities, including direct consumption of antibiotics by humans at community and hospital levels and consumption by animals. The figure is reproduced from www.antibioticfootprint.net under the terms of the Creative Commons Attribution 4.0. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.

Figure 2.

Examples of antibiotic footprint (a) by country (metric tonnes) and (b) per capita (grams per person) in 2015 based on official and open-access data for the countries shown. Only official and open-access data from each country were used. Antibiotic consumption data in humans were based on open-access official data in the WHO Report on Surveillance of Antibiotic Consumption. Data on antibiotic consumption in animal agriculture were based on the annual report of the World Organization for Animal Health (OIE). Data are available for the year 2015 from the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC), the US FDA, the Agricultural and Livestock Service, Chile (SAG), and the Ministry of Agriculture, Forestry and Fishery, Japan (MAFF). Of 62 countries with official data on antibiotic consumptions in 2015, 25 (40%) had data across all sectors (humans at community and hospital levels and animals). Those included Japan and 24 European countries.^, The figure is reproduced from www.antibioticfootprint.net under the terms of the Creative Commons Attribution 4.0. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.

Figure 3.

An example of the antibiotic footprint of a country based on antibiotic consumption in the UK in 2017. The country antibiotic footprint is defined here as the total amount of antibiotics consumed in the country. Total antibiotic consumption for human use and animal use was based on the UK One Health Report. The figure is reproduced from www.antibioticfootprint.net under the terms of the Creative Commons Attribution 4.0. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.