The Netherlands and Greece present a stark contrast in Europe’s ongoing battle with antimicrobial resistance, with the former reporting 9.8 daily doses of antibiotics per 1,000 residents last year, while the latter recorded nearly triple that figure at 29.9. This significant disparity underscores a broader challenge facing the continent, where the overuse of antibiotics continues to fuel the evolution of drug-resistant pathogens. These resistant strains are responsible for over 35,000 deaths annually across the European Union, Iceland, Liechtenstein, and Norway, a grim statistic that highlights the urgency of addressing antibiotic consumption.
Despite calls from the EU Council in 2023 for member states to reduce their antibiotic use and ensure that at least 65 percent of prescribed antibiotics are first-line treatments, the continent as a whole has not met these objectives. Data from the European Centre for Disease Prevention and Control (ECDC) indicates that in 2024, the average daily dose across the EU stood at 20.3 per 1,000 residents. This figure represents a two percent increase compared to the pre-pandemic baseline of 2019 and remains considerably higher than the EU’s ambitious target of 15.9 daily doses by 2030. The ECDC recently warned that progress toward these critical targets remains insufficient, prompting renewed calls for concerted action.
The uneven pace of implementation for health guidance across Europe contributes significantly to these divergent national figures. Evelyne Jouvin Marche, who coordinates scientific research on antibiotic resistance at Inserm, France’s National Institute of Health and Medical Research, observes that the “rollout between countries is not exactly the same.” This suggests that while official directives exist, their translation into clinical practice—from hospitals and doctors to clinics and individual patients—varies widely. Some nations have evidently made more headway in integrating these practices than others, leading to the observed national differences in antibiotic consumption.
Alarmingly, trends in several countries show an increase in antibiotic use since 2020. ECDC data reveals that Austria, Belgium, Croatia, Estonia, Finland, France, Iceland, Latvia, Lithuania, Luxembourg, Norway, Portugal, Slovenia, and Spain have all seen their antibiotic consumption rise. This regression in many regions points to a systemic issue, suggesting that current strategies are not universally effective in curbing the tide of overuse. The ECDC emphasized in a November report that the “poor progress towards the EU targets on antimicrobial consumption… highlights the need to strengthen efforts to address unnecessary and inappropriate antimicrobial use at all levels of health care.”
Addressing this complex issue requires a multi-faceted approach. The ECDC advocates for countries to update their diagnostic practices to better account for the risks associated with antibiotic overuse. Furthermore, enhanced measures for infection prevention and control are deemed crucial. Beyond national policies, broader societal factors complicate the fight against antimicrobial resistance. The increasing mobility of populations means that drug-resistant pathogens can spread rapidly across borders, posing a global health threat. Additionally, Europe’s aging demographic means a larger proportion of the population is more vulnerable to infections, potentially driving up antibiotic prescriptions.
Individuals also play a role in mitigating the rise of resistance. Jouvin Marche advises patients to complete their full course of prescribed medication when battling an infection, rather than discarding unused doses or saving them for future ailments. She stresses that the prescribed amount is precisely what is needed to treat the current infection, and deviating from this can inadvertently contribute to the development of resistant bacteria. The collective effort of policymakers, healthcare professionals, and the public will be essential in navigating this growing public health crisis and safeguarding the efficacy of these vital medicines.
