Comparative Trends in Human and Veterinary Antimicrobial Consumption in the European Union, 2019–2024

Antimicrobial resistance (AMR) is a global health crisis addressed through a One Health framework. However, recent European Union (EU) surveillance data reveals a marked divergence in progress between the human and animal sectors. This study analyzes the most recent monitoring reports (European Surveillance of Antimicrobial Consumption Network and European Sales and Use of Antimicrobials for Veterinary Medicine, 2024) to compare the effectiveness of mitigation strategies across sectors. The findings expose a clear paradox: while the veterinary sector has achieved a structural 24.3% reduction in antimicrobial sales in the EU since 2018, human medicine has recorded a 2% increase in overall consumption, diverging from established reduction targets. From a qualitative perspective, veterinary medicine has nearly eliminated the use of critically important antimicrobials in the AntiMicrobial Expert Group (AMEG) (category B), including polymyxins and third-generation cephalosporins, which now account for only 0.24% of total sales. In contrast, human medicine continues to struggle to contain antimicrobial resistance in key sentinel pathogens, notably Klebsiella pneumoniae and Escherichia coli. Furthermore, companion animals, representing 97.9% of non-food-producing animal biomass, emerge as a reservoir of antimicrobial-resistant bacteria due to the intensive use of broad-spectrum oral formulations. The results indicate that the veterinary regulatory model, centered on binding volume reduction and preventive strategies, has been more effective in reducing overall antimicrobial consumption compared to the voluntary, guideline-based stewardship approaches currently used in human medicine. Achieving meaningful control of antimicrobial resistance will require human medicine to adopt the same level of structural rigor already implemented in animal production systems.