Swedres-Svarm reports

For a long time, Sweden has had a favourable situation compared to many other countries regarding antibiotic resistance in bacteria from humans. This continues to be true. One contributing factor is our effective strategies to promote the responsible use of antibiotics and limit the spread of antibiotic resistance.

Despite the favourable situation, continuously increasing antibiotic resistance and the spread of resistant bacteria in healthcare is concerning. Important examples are the recurrent outbreaks of vancomycin-resistant enterococci in hospitals and an increasing number of healthcare-associated clusters of ESBLCARBA. This emphasises the importance of continuous work with antibiotic stewardship and infection prevention and control, in healthcare as well as in the community, to prevent increasing antibiotic resistance.

Antibiotic sales in human medicine in Sweden decreased sharply during the pandemic, but began to increase in 2022 and continued in 2023. In 2024, the increase has slowed and sales are essentially unchanged compared to the previous year. The sales remain below pre-pandemic levels. Antibiotic sales have generally decreased since the peak in 1992. The greatest decrease during this period was observed in children aged 0-4 years.

In veterinary medicine, sales of antibiotics have decreased markedly since the mid-1980s, and in recent years sales seem to have stabilised at a comparatively low level. The occurrence of resistance among bacteria from animals has generally been stable at low or moderate levels. For some substances and in some bacteria, the occurrence of resistance is even declining. One example of this is a significant decline in the occurrence of ESBL-producing Escherichia coli among broilers. There are, however, exceptions. For example, resistance to ampicillin, sulphonamides and trimethoprim has increased in indicator E.coli from both broilers and pigs.