Antibiotics Market Size, Share & COVID-19 Impact Analysis, By Drug Class (Penicillin, Cephalosporin, Aminoglycosides, Tetracycline, Macrolides, Fluoroquinolones, Sulfonamides, and Others), By Application (Skin Infections, Respiratory Infections, Urinary Tract Infections, Septicemia, Ear Infection, Gastrointestinal Infections, and Others), By Route of Administration (Oral, Parenteral, and Others), By Distribution Channel (Hospital Pharmacy, Retail Pharmacy, and Online Pharmacy), and Regional Forecast, 2021-2028

The global antibiotics market size was USD 37.35 billion in 2020 and is projected to grow from USD 38.08 billion in 2021 to USD 45.30 billion in 2028, exhibiting a CAGR of 2.5% during the 2021-2028 period. Based on our analysis, the global market exhibited a negative growth of -13.74% in 2020 as compared to the average year-on-year growth during 2017-2019. The global impact of COVID-19 has been unprecedented and staggering, with antibiotics witnessing a negative impact on demand across all regions amid the pandemic. The rise in CAGR is attributable to this market’s demand and growth, returning to pre-pandemic levels once the pandemic is over.

There is a gradual decline in the consumption of the product especially in the United States, Canada, and European countries. This is primarily due to the rising emphasis of regional and national government agencies and non-profit organizations towards reducing the burden of antimicrobial resistance caused due to the overuse of these drugs.

• According to the Center for Disease Dynamics, Economics & Policy (CDDEP), the defined daily doses of antibiotics consumed in the U.S., decreased by 19.8% from 3,630 million in 2010 to 2,913 million in 2020.

Several government agencies and regional healthcare organizations are taking initiatives to restrict the overuse and misuse of antibiotics in these countries.

• For instance, in 2015, the Federal Cabinet approved the German Antibiotic Resistance Strategy, DART 2020. At the same time, the Global Action Plan on Antimicrobial Resistance was adopted by the World Health Assembly.

However, there is a marked increase in the consumption of these drugs in developing countries including China, India, and countries in the Middle East & Africa. The rising prevalence of infectious diseases and the growing preference of healthcare providers towards oral drugs in these countries are leading to the higher consumption of these drugs in these countries. This, combined with the increasing number of hospital admissions and the growing focus of healthcare agencies towards the reduction of hospital acquired infections in these countries, is driving the demand for these drugs.

• For instance, according to the Centre for Disease Dynamics, Economics & Policy (CDDEP), the total consumption of antibiotics in Brazil was 1,906 million defined daily doses (DDD) in 2020. This was a marked increase of 75.6% from 1,085 million defined daily doses (DDDs) in 2010.

This, combined with the surging collaborations between leading organizations and key players for the development of broad spectrum antibiotics is driving the growth of the market.

• The ground-breaking AMR Action Fund expects to invest more than USD 1 billion to bridge the funding gap and respond to the threat of the growing antimicrobial resistance. The Fund aims to bring 2-4 new drugs to the market this decade to save patient lives.

Such new initiatives and collaborations are projected to contribute to the overall market growth.

Market to Witness a Negative Impact Owing to Declining Prescribing Practices across Healthcare amid COVID-19 Pandemic

The market witnessed negative growth in terms of revenues in 2020, owing to the impact of COVID-19 on various segments. The outbreak of COVID-19 has had an adverse impact on the market. The Centers for Disease Control and Prevention (CDC) monitored the effects of the COVID-19 pandemic on antibacterial drugs prescribing practices across the healthcare sector. Changes in prescribing habits have been observed during the pandemic due to the healthcare access changes.

Amid the COVID-19 pandemic, patients avoided visiting healthcare settings for non-urgent medical needs. Also, the lower overall bacterial infection rates due to school closures and social distancing played crucial roles in hindering the market growth in 2020. Additionally, key players have reported a decline in their revenues from the sales of antibacterial drugs during the COVID-19 pandemic.

• For instance, Merck & CO. brands, Primaxin, Invanz, and Cubicin reported a decline in the total sales of 8.1%, 19.8%, and 40.9%, respectively in 2020 due to the COVID-19 pandemic. These factors are attributed to the negative impact of COVID-19 on the market.

LATEST TRENDS

Rigorous R&D Activities to Develop Advanced Combination Therapies to Treat Antibiotic-resistant Infections is a Vital Trend

Due to the rising awareness about antibiotic-resistant infections, biopharmaceutical companies are focusing on developing advanced combination therapies. For instance, in 2021, Allecra Therapeutics GmbH is developing cefepime/enmetazobactam to address the critical resistance issues. Cefepime/enmetazobactam has completed a pivotal Phase III trial (ALLIUM) in Complicated Urinary Tract Infections (cUTI).

Additionally, in September 2018, a group of UCLA biologists worked with eight antibiotics and analyzed how every possible four and five drug combination, including many with varying dosages, led to 18,278 combinations in all, and all worked against E. coli. They anticipated that few of the combinations would be very efficient at killing the bacteria.

Such alignments will definitely open numerous opportunities and foster the global antibiotics market growth during the forecast period.

DRIVING FACTORS

Rising Prevalence of Bacterial Infections to Propel the Market Growth

The increasing prevalence of several bacterial infections across the globe is one of the major factors supporting the growth of the market. Bacterial infections include Urinary Tract Infection (UTI), respiratory infections, tuberculosis, skin infections, and others. The global burden of bacterial infections is increasing and is projected to become the most common cause of years of life lost globally by 2050. A Urinary Tract Infection (UTI) is an infection in any section of the urinary system, i.e., kidneys, urethra, ureters, and bladder.

• According to the World Health Organization prediction report, about 50% of women report having had a UTI at some point in their lives.


• Furthermore, according to the World Health Organization (WHO), 1.4 million people died from tuberculosis in 2019. Worldwide, tuberculosis is one of the top 10 causes of death and the leading cause of a single infectious agent.

Moreover, the increasing demand for innovative treatment options has led to a surge in the R&D spending of pharmaceutical companies to develop therapeutically effective antibacterial drugs, along with a focus on strengthening the supply chain through the adoption of digital technologies.

RESTRAINING FACTORS

Surging Antimicrobial Resistance to Restrict Market Growth

The prolonged use of various antibacterial drugs such as broad-spectrum antibiotics has augmented the antimicrobial resistance (AMR) among patients. The misuse and overuse of antimicrobials are the main drivers in the development of drug-resistant pathogens

• According to the Centers for Disease Control and Prevention (CDC) report, more than 2.8 million antibiotic-resistant infections occur in the U.S. each year.


• Additionally, each year, AMR is responsible for about 33,000 deaths and costs about USD 1.1 billion to the health care systems of EU/EEA countries.

This has led to the increasing number of healthcare agencies taking various initiatives to restrict the excessive and unwanted use of antibacterial drugs. For instance, in 2016, the Global Antibiotic Research and Development Partnership (GARDP) was created by WHO and DNDi to deliver on the Global Action Plan on Antimicrobial Resistance.

SEGMENTATION

By Drug Class Analysis

Penicillin Segment to Hold Major Portion of the Market

Based on the drug class, the global market is segmented into penicillin, cephalosporin, aminoglycosides, tetracycline, macrolides, fluoroquinolones, sulfonamides, and others.

The penicillin segment held the dominant share of the global market in 2020 due to its increased sales for numerous bacterial infections. Additionally, the rising usage of penicillin’s in several developing and developed countries would contribute to the high share of the segment.

According to the Organization of Economic Co-operation and Development (OECD), countries such as Hong Kong, South Korea, Spain, Italy, and others demonstrated a comparatively higher consumption of broad spectrum and narrow spectrum penicillin, as compared to other drug classes.

• In South Korea, in 2019, penicillin were the most commonly prescribed drugs, that accounted for around 45% of the total consumption (in daily defined doses per 1,000 inhabitants) in the country.


• According to the European Centre for Disease Prevention and Control (ECDC), in 2017, penicillin was the most frequently prescribed drug class in all European countries, ranging from 33% (Germany) to 67% (Slovenia) of the total consumption in these countries.

The cephalosporin segment is anticipated to expand at a higher CAGR during the forecast period. This growth is attributable to the higher investments in the manufacturing of therapeutically effective drugs for bacterial infectious diseases such as ear infections, skin infections, upper respiratory tract infections, urinary tract infections, and others. Additionally, the high usage of cephalosporin’s in developed countries would contribute to the surging growth of the market. According to the Center for Disease Dynamics, Economics & Policy, developed countries such as Japan have high consumption of cephalosporin, as compared to other antibacterial drugs.

Macrolides, tetracycline, fluoroquinolones, and other drug classes have shown marked variations in preference among healthcare providers in different countries. According to The European Statistical Advisory Committee (ESAC), the consumption of tetracycline’s (in daily defined doses per 1,000 inhabitants) in Italy, Spain, and Germany was comparatively lower (around 5% to 15% of the total consumption). This was markedly different from the consumption of this class in France and the U.K. (from 15% to 25% of the total consumption).

By Application Analysis

Rising Prevalence of Respiratory Infections is Attributed to Higher Share of the Segment

Based on application, this market is classified as skin infections, respiratory infections, urinary tract infections, septicemia, ear infection, gastrointestinal infections, and others.

The respiratory infections segment held the dominating share in 2020. This higher share is attributable to the growing incidence rate of several respiratory infections leading to the demand for effective products for treatment.

• According to the UNICEF analysis, 5 million children are dying every year from mostly preventable causes. Pneumonia is responsible for nearly 20% of these deaths and is the leading infectious cause of death in this age group.

The rising demand for drugs to treat these diseases is anticipated to boost the segmental growth.

Furthermore, the urinary tract infections (UTI) application segment is anticipated to hold the second-highest share of the market.

• According to the CDC report, urinary tract infections (UTIs) are the fifth most common type of healthcare-associated infection, with an estimated 62,700 UTIs in acute care hospitals in 2015. UTIs additionally account for more than 9.5% of infections reported by acute care hospitals.


• Additionally, approximately 12%-16% of adult hospital inpatients will have an indwelling urinary catheter (IUC) at some time during their hospitalization. Therefore, it is anticipated to boost the growth of the segment during the forecast period.

Moreover, the skin infections and gastrointestinal infections segments captured considerable market share in 2020 and are projected to secure an increased market share by the end of 2028. Potential pipeline candidates in clinical trials are anticipated to boost growth of the segment during the forecast timeframe. For instance, companies such as Helperby Therapeutics Ltd., have potential candidates in R&D for the treatment against bacterial skin infections.

By Route of Administration Analysis

High Share of the Parenteral Route of Administration Attributed to an Increasing Incidence of Hospital Acquired Infections (HAIs) 

Based on the route of administration, the global market is classified as oral, parenteral, and others.

The parenteral segment dominated the global market in 2020. The increasing technological advancements and precise dosage delivery of these drugs through syringes are expected to surge the demand for the parenteral route of administration during the forecast period.

Furthermore, the higher CAGR of the parenteral segment is attributed to the gradually increasing number of inpatient admissions in hospitals globally. This, along with the rising average length of stay (LOS) in these settings is leading to the higher number of patients suffering from hospital acquired infections globally.

The Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), National Health Service (NHS), and other agencies have established guidelines for the management of HAIs, which suggests the use of parenteral drugs as prophylaxis for HAIs. These factors are anticipated to boost the parenteral segment during the forecast period.

On the other hand, the oral segment holds a significant share of the market. The increasing number of patients opting for the self-administration of drugs is the prominent factor projected to boost the segmental growth during the forecast period.

By Distribution Channel Analysis

Online Pharmacies Segment to Exhibit High Growth in the Near Future

The global market is segmented into hospital pharmacies, retail pharmacies, and online pharmacies based on distribution channels.

Large patient populations tend to prefer treatment in hospitals. Also, the increasing number of specialized hospitals are the key factors anticipated to have an impact on the growth of the hospital pharmacies segment during the forecast period. The segment held the dominating share in 2020.

Drastic growth in online delivery and purchase of medicines is projected to be observed in the forecast timeframe due to the increased adoption of advanced technology by middle-income countries. The pandemic crisis has contributed heavily to the preference of online pharmacies over retail. Therefore, it is anticipated to boost the growth of the segment during the forecast period.

REGIONAL INSIGHTS

On the basis of region, the global market can be segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East and Africa.

The market in North America stood at USD 16.81 billion in 2020 and is anticipated to continue to dominate the global market during the forecast period. The augmented inclination of key players to introduce new products in developed countries of North America is a key factor driving the growth of the market in the region.

• For instance, in January 2020, Merck & Co., Inc. announced the U.S. FDA approval for its DIFICID (fidaxomicin) for oral suspension and a supplemental New Drug Application (sNDA) for DIFICID tablets for the treatment of Clostridioides (formerly Clostridium) difficile-associated diarrhea (CDAD) in children aged six months and older.

Thus, the novel launch of effective products is likely to aid growth of the market in this region.

Europe is anticipated to be the second-most dominant region in terms of market share. The prompt development of healthcare infrastructure in several European countries, the increasing investment in research and development activities, and the rising number of hospitals in the region are the key aspects driving the demand for these drugs in the European market.

The market in Asia Pacific is estimated to grow at the highest CAGR. China and India are set to showcase a rise in antibiotics consumption.

• According to the Center for Disease Dynamics, Economics & Policy, the consumption in defined daily doses (DDD) in China, and India increased by 297.3% & 47.4%, respectively during 2010-2020.

Moreover, the rising healthcare expenditure in the region is prominently expected to support the higher usage of these drugs during the forecast period.

Latin America and the Middle East & Africa are projected to account for insignificant market revenue share during the forecast period. The emerging healthcare sector and the increasing awareness about several bacterial infections are expected to augment growth of the market in these regions during 2021-2028.

KEY INDUSTRY PLAYERS

Pfizer Inc., Abbott Laboratories, Novartis AG, and Merck & Co., Inc. are Key Players in the Market

This market is fragmented with players, such as Pfizer Inc., Abbott Laboratories, Novartis AG, and Merck & Co., Inc. accounting for a substantial share in 2020. The top market players are focusing on strategies, such as acquisitions, collaborations, and new product developments and launches to strengthen their positions globally.

• For instance, in February 2021, Sandoz, a Novartis division, signed an agreement to acquire GSK’s cephalosporin business, reinforcing its leading global position in the market.

Other key players with an important presence in the global market include GlaxoSmithKline plc, Sanofi, Astellas Pharma Inc., Johnson & Johnson Services, Inc., Bayer AG, and Bristol-Myers Squibb Company. These companies are anticipated to focus on new product launches to increase their market share during the forecast period.

LIST OF KEY COMPANIES PROFILED:

• Pfizer Inc. (New York, U.S.)


• Abbott (Illinois, U.S.)


• GlaxoSmithKline plc. (London, U.K.)


• Sanofi (Paris, France)


• Novartis AG (Basel, Switzerland)


• Bayer AG (Leverkusen, Germany)


• Bristol-Myers Squibb Company (New York City, U.S.)


• Merck & Co., Inc. (Kenilworth, U.S.)


• Astellas Pharma Inc. (Tokyo, Japan)


• Johnson &Johnson Services, Inc. (Janssen Pharmaceuticals, Inc.) (New Brunswick, U.S.)

KEY INDUSTRY DEVELOPMENTS:

• July 2019 – Pfizer entered into a definitive agreement with Mylan, creating a new company, Viatris. This merger helped Pfizer to expand its global reach.


• March 2017 - Pfizer Inc. announced the launch of an important new product called Zavicefta (ceftazidime-avibactam) in the U.K., and Germany.

REPORT COVERAGE

The global market report provides detailed industry analysis and focuses on key aspects, such as an overview of the advanced product, the rising number of several bacterial infections, key countries, and pricing analysis. Additionally, it includes an overview of reimbursement scenarios for treatment, key industry developments such as mergers, partnerships, & acquisitions, the impact of COVID-19 on the market, and brand analysis. Besides these, it offers insights into the antibiotics market trends and highlights key industry developments. In addition to the aforementioned factors, it encompasses several factors that have contributed to the growth of the market over recent years. The report also covers regional analysis of different segments.

Report Scope & Segmentation

ATTRIBUTE	DETAILS
Study Period	2017-2028
Base Year	2020
Estimated Year	2021
Forecast Period	2021-2029
Historical Period	2017-2019
Unit	Value (USD billion)
Segmentation	Drug Class, Application, Route of Administration, Distribution Channel, and Region
By Drug Class	Penicillin Cephalosporin Aminoglycosides Tetracycline Macrolides Fluoroquinolones Sulfonamides Others
By Application	Skin Infections Respiratory Infections Urinary Tract Infections Septicemia Ear Infection Gastrointestinal Infections Others
By Route of Administration	Oral Parenteral Others
By Distribution Channel	Hospital Pharmacy Retail Pharmacy Online Pharmacy
By Geography	North America (U.S. and Canada) Europe (U.K., Germany, France, Italy, Spain, Scandinavia, and the Rest of Europe) Asia-Pacific (Japan, China, India, Australia, Southeast Asia, and the Rest of Asia- Pacific) Latin America (Brazil, Mexico, Rest of Latin America) Middle East & Africa (GCC, South Africa, Rest of the Middle East & Africa)