Overuse of Powerful Antibiotics Driving Global Drug Resistance, WHO Warns

The overuse of certain antibiotics—especially those with a high potential to drive drug resistance—is threatening to undermine global efforts to combat antimicrobial resistance (AMR), the World Health Organization (WHO) has warned in a new report released today.

The report, based on 2022 data from WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the AWaRe classification system, reveals that many countries are falling short of a key target aimed at curbing antibiotic misuse.

According to the findings, “Watch” antibiotics—broad-spectrum drugs intended for more severe infections—are being used excessively in many countries. These antibiotics are more likely to contribute to the development of AMR, yet they continue to be prescribed when safer and more targeted options, known as “Access” antibiotics, would suffice.

The WHO recommends that Access antibiotics, which are cost-effective and carry a lower risk of resistance, should account for at least 70% of global antibiotic use by 2030. However, only one in three countries, territories, or areas (CTAs) currently meets that target.

“Unnecessary use of Watch antibiotics must be avoided,” the report emphasizes, “especially when Access antibiotics would be effective or no antibiotics are needed at all.”

Since GLASS began tracking antibiotic use in 2020, only 90 CTAs have enrolled, with 74 reporting national data by the end of 2023. This represents less than half of the global total, with substantial data gaps in low-income and non-European regions.

The report highlights stark disparities in antibiotic use, noting a tenfold difference between the highest- and lowest-using countries. In 2022, the median antibiotic consumption was 18.3 defined daily doses per 1,000 inhabitants per day. The wide variation suggests both overuse in some regions and inadequate access in others.

Notably, some low- and middle-income countries reported little or no use of “Reserve” antibiotics—last-resort treatments for infections caused by multidrug-resistant bacteria. Their absence points to potential shortages that could prove fatal for patients in need.

The WHO says the findings carry immediate implications for global health policy. It plans to continue assisting countries in building sustainable surveillance systems to gather high-quality data on antibiotic use. An online course through the WHO Academy will be launched to improve training on measuring and interpreting these data.

In addition, countries are being urged to implement stewardship policies to ensure that prescribers prioritize Access antibiotics whenever possible and reduce unnecessary prescriptions. WHO will collaborate with key partners, including the World Medical Association, to support responsible prescribing practices among healthcare professionals.

At the same time, efforts are being made to improve access to essential antibiotics—particularly Reserve antibiotics—in countries with limited resources. WHO is working alongside organizations such as the Global Antibiotic Research and Development Partnership to create a framework that addresses supply challenges in underserved regions.

Antimicrobial resistance occurs when bacteria, viruses, fungi, or parasites evolve to resist treatment, making common infections harder—or even impossible—to cure. This growing crisis threatens to reverse decades of medical progress and poses a serious threat to global health.

“Overuse and misuse of antibiotics are fueling AMR, but in many regions, the problem is compounded by poor access to essential medicines,” the WHO cautioned.

As the world prepares for the 2024 UN General Assembly High-Level Meeting on AMR, the latest findings underscore the urgent need for coordinated global action to preserve the effectiveness of antibiotics and safeguard public health.