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Antibiotics and One Health
The discovery of antibiotics is one of the greatest discoveries in medicine, but unfortunately, antibiotic resistance is on the rise. Resistant pathogens do not respect borders and are readily transmissible. The World Health Organization (WHO) has declared antibiotic resistance to be one of the major health threats today.

One Health is a comprehensive vision that encompasses the health of people, animals and the environment. The term is particularly relevant in the fight against antibiotic resistance, but resistant pathogens are easily transmitted between humans, animals and the environment. Earlier this year, the Council of the European Union adopted a recommendation aimed at promoting action against antibiotic resistance. The Council's recommendation is to promote the rational use of antibiotics in humans and animals to reduce antibiotic resistance.

Icelandic measures
In Iceland, the plan is to strengthen interdisciplinary collaboration on actions against antibiotic resistance. About a year ago, a working group was appointed, but the project is being carried out in collaboration with the Ministry of Health, Food and Environment, Energy and Climate. The working group has the task of formulating a future vision for the next ten years. The group is also charged with developing an action plan and implementation plan on antibiotic resistance for the next five years, as well as raising awareness in Iceland.

Antibiotic use and resistance of pathogens in Iceland
Icelanders continue to use more antibiotics than other Nordic countries but are moderate compared to EU/EEA countries. Total antibiotic sales in Iceland increased in 2022 compared to the previous two years. The incidence of infections was reduced temporarily during the COVID-19 pandemic in 2020 and 2021, most likely due to extensive disease prevention measures.

Total antibiotic sales for animals in Iceland in 2022 were close to one-third higher than the year before, which is explained solely by antibiotic administration in land-based farming of Arctic charr due to the presence of furunculosis. If this antibiotic sales is subtracted, it is evident that sales of antibiotics for animals have declined in recent years.

Iceland has a low rate of antibiotic-resistant bacteria compared to many other European countries. However, the detection of bacteria resistant to important antibiotics, such as penicillins and cephalosporins, has increased in the past decade. This trend has also taken place elsewhere in Europe and the world.

The situation in Iceland
The situation in Iceland is good in many respects concerning the use of antibiotics and antibiotic resistance, but much work is still to be done. With joint efforts, we protect antibiotics and reduce the spread of resistant pathogens in Iceland and the world.

Further information:

• Antibiotic use and antibiotic susceptibility in humans and animals in Iceland 2022 (Icelandic)

• Older annual reports on antibiotic use and antibiotic susceptibility (Icelandic)

The Chief Epidemiologist