The Top 35 Countries by Antibiotic Use

Antibiotics revolutionized medicine, but overuse accelerates drug-resistant “superbugs.”

This ranking shows the countries with the most antibiotic use, measured by defined daily doses (DDD) per 1,000 people.

Data for this visualization comes from Our World in Data and the One Health Trust as of 2022. Figures are rounded.

Skip to the second-last section for more information about how this data was collected.

Iran and Emerging Economies Lead Antibiotic Consumption

Iran’s 68 DDD per 1,000 people is more than triple the global median (18 DDD), reflecting looser prescription controls and ease of over-the-counter access

A recent study found that nearly half of outpatient antibiotic prescriptions in Iran “lacked medical justification.”

Iran is not the only middle-income country with a high antibiotic use.

South Africa (51 DDD) and Egypt (50 DDD) follow close behind.

Even poorer economies such as Bangladesh and Tanzania post rates above 35 DDD, outstripping any EU member.

High DDDs can indicate that a country either faces a heavy disease burden or is experiencing over-prescription and misuse.

Misuse is most common in low- and middle-income countries, where health care access is limited. Weak enforcement of sales rules lets pharmacies and informal sellers dispense antibiotics freely.

Europe Shows a Wide Spread in Antibiotic Use

Within Europe, southern nations use far more antibiotics than their northern neighbors.

France, Malta, Italy, and Spain all hover around 24–25 DDD.

Meanwhile Nordic countries like Denmark, Norway, and Finland sit near or below 15 DDD (not in the graphic but listed in the table above.)

Cultural attitudes toward prescribing, national action plans, and availability of narrow-spectrum alternatives all influence these disparities.

U.S. Antibiotic Use

At 22 DDD, the U.S. places 23rd out of the 35 countries shown, higher than Canada (15 DDD) and the U.K. (20 DDD), yet lower than much of Southern Europe.

Studies show outpatient prescriptions have fallen 13% between 2011–2019, thanks to campaigns that target inappropriate treatment of viral infections.

Still, about one in three American prescriptions is considered unnecessary, suggesting considerable room to close the gap with low-use peers like Germany (10 DDD per 1,000 people).

ow Do Sources Track Antibiotic Use?

Our World in Data is the primary source for this graphic and article. It processes figures from the WHO’s GLASS platform, which countries feed with standardized data so researchers can compare antimicrobial consumption across regions.

Participating countries report national antimicrobial use from sources like insurance claims, import records, and hospital prescriptions, including antituberculosis drugs. GLASS enforces a common methodology to ensure consistency.

The One Health Trust draws on the IQVIA MIDAS database to estimate national antibiotic consumption from retail and hospital pharmacy sales.

It samples manufacturer and wholesaler sales across distribution channels and scales them to national totals using a proprietary algorithm that applies regional, sector-specific, and channel-specific factors.

The exact algorithm remains undisclosed.

TEMA