National-Level Actions Effective at Tackling Antibiotic Resistance

National-level policies can reduce the impact of antibiotic resistance across diverse countries, according to a study published April 30, 2025 in the open-access journal PLOS Global Public Health by Peter Søgaard Jørgensen from Stockholm University and the Royal Swedish Academy of Sciences, Sweden, and colleagues.

Antibiotic resistance is a major public health concern, contributing to 1.27 million deaths per year. In 2016, countries around the world committed to developing and implementing national action plans to combat antibiotic resistance. These plans have been criticized for not being fully operationalized. Assessing their impact is challenging—change doesn’t happen overnight, not all countries report their data systematically, and the COVID-19 pandemic disrupted monitoring.

In this study, researchers used the Global Database for Tracking Antimicrobial Resistance Country Self- Assessment Survey (TrACSS) and data on antibiotic use and antibiotic resistance to evaluate the impact of national action over time in 73 countries, representing six continents across high and low-middle income countries. They looked at national trends in indicators related to antibiotic resistance, including antibiotic use, rates of antibiotic resistance, and impact of resistant infections.

By assigning each country an action index, they found that national action was consistently associated with improved indicators of antibiotic resistance. These associations persisted after controlling for factors like socioeconomic conditions, population density, and climate.

Since 2016, both high and low-middle income countries have become more ambitious with their national action plans; only one-third have decreased their efforts to reduce antibiotic resistance.

The authors noted some bias in their sample size in that high-income countries are more likely to have established monitoring systems but stressed the importance of studies like this to establishing the impact of national policies on tackling antibiotic resistance.

 The authors add: “Our research shows the importance of all countries taking additional action to address antibiotic resistance. Very ambitious action will be needed to achieve reductions in resistance, but even incremental improvements will help reduce the projected increases…We were not sure that it would be possible to reduce levels of antibiotic resistance while also keeping using antibiotics to the extent that is required by modern health systems, but our research indicates that it is indeed possible.”

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In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://plos.io/3Gv8DR4

Citation: Søgaard Jørgensen P, Thanh LN, Pehlivanoğlu E, Klein F, Wernli D, Jasovsky D, et al. (2025) Association between national action and trends in antibiotic resistance: an analysis of 73 countries from 2000 to 2023. PLOS Glob Public Health 5(4): e0004127. https://doi.org/10.1371/journal.pgph.0004127

Author Countries: Sweden, Switzerland, United States

Funding: We acknowledge funding from the Erling-Persson Family Foundation (P.S.J., L.N.T., E.P., F.K.), the European Union (ERC, INFLUX, 101039376, P.S.J.), the IKEA Foundation (P.S.J.), the Marianne and Marcus Wallenberg Foundation (P.S.J) and the Uppsala Antibiotic Centre (UAC, L.N.T.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council. Neither the European Union nor the granting authorities can be held responsible for them. We thank SESYNC for support for the Living with Resistance pursuit, which this paper is a product of.