2.2 Antimicrobial consumption data related to human health

In the module Introducing AMR surveillance systems, you were introduced to the concept of antimicrobial consumption (AMC).

  • Can you recall the definition of AMC?

  • AMC is defined in terms of the ‘sale’ of antimicrobial medicines.

The ‘sale’ of antimicrobials is captured by way of national-level estimates of the quantities of antimicrobials imported and manufactured. These estimates are mainly derived from import, sales or reimbursement databases. Such data can serve as proxy for actual use of antibiotics, for which data collection is often more difficult. AMC data is typically expressed in terms of a defined daily dose (DDD) (WHO, 2020). For all medicines, a WHO resource is maintained that describes what the expected dose of that medicine for a 70kg adult human is – this is the defined daily dose.

GLASS, via its GLASS-AMC routine data surveillance activity, launched in 2019, asks national AMR surveillance systems to submit AMC data aggregated at national level. AMC data requirements centre around lists of registered antimicrobial medicines, the quantity of antimicrobials used and related contextual information. When countries submit AMC data to GLASS, the WHO then gives feedback of comparison of the levels of consumption of antimicrobials against other countries.

AMC data analyses at national level should aid the understanding of the trends and amount of antimicrobials used nationally. Overall use of particular antimicrobials within a country is a major driver of the local level of resistance to that agent, though some drugs may be used predominantly within one or other sectors. AMC data therefore gives useful information on what amount of evolutionary pressure is being exerted by the use of these antimicrobials within the country. Such analyses help drive national policies, strategies and interventions to optimise the use of antimicrobials.

National AMR surveillance systems are able to benefit from this unified approach to mitigating AMR by way of participating (sharing data) with GLASS-AMR and GLASS-AMC, respectively. Figure 1 shows a map of countries (as of 2020) enrolled in GLASS-AMR and/or GLASS-AMC.

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Figure 1 Map of enrolment in GLASS-AMR and/or GLASS-AMC (WHO, 2020).
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This map shows which countries are enrolled in different data surveillance systems; a system to monitor antimicrobial consumption (AMC) at the national level (in yellow) and a system for collection, analysis and sharing of national data on antimicrobial resistance (AMR) in samples collected routinely for clinical purposes for the priority pathogens (in purple), or countries that are enrolled in both systems (in blue) (WHO, 2020).

Figure 1 Map of enrolment in GLASS-AMR and/or GLASS-AMC (WHO, 2020).

  • Now that you’ve reacquainted yourself with the concept of AMC and why monitoring trends in antimicrobial consumption is important, please take a moment to answer the following question.

    Does improper and widespread use of antibiotics diminish, increase, undermine or prevent the rate of antibiotic resistance?

  • Improper and widespread use of antibiotics increases the rate of antibiotic resistance.

2.1 Focus on priority bacterial pathogens related to human health

3 The structure of national AMR surveillance systems