The Top 35 Countries by Antibiotic Use—See Where the U.S. Ranks

The Top 35 Countries by Antibiotic Use—See Where the U.S. Ranks

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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.

DDD: A typical adult’s one-day treatment (for the drug’s main use).

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.

Rank	Country	Daily dose of antibiotics (DDD), used per 1,000 inhabitants, 2022
1	Iran	68
2	South Africa	51
3	Egypt	50
4	Bangladesh	49
5	Tanzania	35
6	Jordan	34
7	Cyprus	34
8	Montenegro	33
9	Nepal	32
10	Laos	30
11	Romania	29
12	Tunisia	28
13	France	25
14	Malta	25
15	Poland	24
16	Italy	24
17	Spain	24
18	Uganda	23
19	Benin	23
20	Ireland	23
21	Kuwait	23
22	Palestine	23
23	U.S.*	22
24	Maldives	21
25	Belgium	21
26	Georgia	20
27	Croatia	20
28	Côte d’Ivoire	20
29	UK	20
30	Lithuania	20
31	Iceland	19
32	Portugal	18
33	Colombia	18
34	Czechia	18
35	Tajikistan	17
36	Belarus	17
37	Russia	17
38	Latvia	16
39	Denmark	15
40	Canada	15
41	Hungary	15
42	Hong Kong	14
43	Papua New Guinea	14
44	Estonia	13
45	Bhutan	13
46	Slovenia	13
47	Finland	12
48	Norway	12
49	Malaysia	11
50	Ethiopia	11
51	Austria	11
52	Ukraine	11
53	Switzerland	11
54	Saudi Arabia	11
55	Germany	10
56	Armenia	10
57	Peru	10
58	Rwanda	9
59	Mali	8
60	Qatar	7
61	Oman	6

*Separate source: One Health Trust.

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.

This figure is from One Health Trust as the primary source did not list a comparative U.S. figure.

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).

Related: The U.S. could be short 90,000 primary care physicians by 2037. See how many doctors are available per capita by state right now.

How 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.

Learn More on the Voronoi App

If you enjoyed today’s post, check out Ranked: America’s Most Popular Drugs by Dollars Spent on Voronoi, the new app from Visual Capitalist.

• Source: https://www.visualcapitalist.com/top-35-countries-by-antibiotic-use-see-u-s-ranks/