SouthAfrica now has the second-highest rate of antibiotic use in the world.

According to the World Health Organisation (WHO), which measures usage in Defined Daily Doses (DDD) per 1 000 people, South Africa records 51 DDD – well above most other countries. Only Iran, at 68 DDD, ranks higher. The DDD measure reflects the average one-day treatment for an adult per 1 000 people.

Health experts warn that such high use is driving antimicrobial resistance, making routine infections harder to treat. The WHO has already highlighted rising resistance in SouthAfrican hospitals as a serious health risk.

Researchers say this pattern stems from poor access to primary care, high infection rates, and widespread self-medication, including over-the-counter antibiotic sales. They are calling for stronger drug-control measures and better public education to preserve the effectiveness of vital medicines.