Montenegro is the leading country in Europe in terms of antibiotic consumption, and experts warn that excessive and improper use of this type of medication seriously contributes to the development of antimicrobial resistance, which makes infections more difficult to treat.
According to data provided to MINA by the Institute of Public Health (IJZ) and the Institute of Drugs and Medical Devices (CINMED), the average consumption of antibiotics in Montenegro is about 50 percent higher than the average in European Union (EU) countries, and the country is also among the countries with the highest level of antimicrobial resistance, especially when compared to the EU.
The latest CINMED data from 2024 show that total antibiotic consumption in public and private institutions amounted to 30,83 defined daily doses per thousand inhabitants per day, which is higher than even Greece, which is among the EU countries with the highest antibiotic consumption.
"Comparative data also shows that Montenegro is at the very top in antibiotic consumption in Europe," CINMED said.
The institution warned that excessive and inadequate use of antibiotics directly contributes to the development of antimicrobial resistance, which is one of the greatest global public health challenges today, and appealed for the rational and responsible use of antibiotics.
The Public Health Institute emphasizes that due to such antibiotic consumption in Montenegro, it is necessary to implement comprehensive and coordinated activities through a multidisciplinary approach.
They emphasized that antibiotic consumption is correlated with the development of antimicrobial resistance and that, given the high consumption of antibiotics, the presence of problems in the form of the emergence and spread of bacteria resistant to their effects is expected.
"Montenegro has recorded a high rate of resistance of important pathogens to key antibiotics. A similar situation is present in the region, while compared to EU countries, we are among the countries with the highest level of antimicrobial resistance," the Institute of Public Health said.
According to them, there are numerous reasons for the high consumption of antibiotics in human medicine, and both healthcare workers and citizens themselves bear responsibility for this.
The Public Health Institute said that the Ministry of Health's interdisciplinary commission for combating antimicrobial resistance (NIKRA) has developed a Program for the Control of Bacterial Resistance to Antibiotics with an Action Plan for the period 2026–2028.
The document, as they explained, is currently under consideration, and envisages the implementation of campaigns at the national level, aimed at promoting the rational use of antibiotics and combating antimicrobial resistance.
The Public Health Institute said that they also played a significant and proactive role through public appearances, activities on social networks, continuous medical education, as well as through cooperation with the Robert Koch Institute to strengthen national surveillance of antibiotic consumption, antimicrobial resistance and hospital infections, while simultaneously developing sustainable information solutions.
"Antibiotics are medicines that save lives - but only if used responsibly," the IJZ said, reiterating that their improper and excessive use leads to bacterial resistance to drugs that were once effective.
Public Health Institute: Slight trend of decline in the number of prescriptions prescribed in public institutions
The Public Health Institute receives data on antibiotic consumption from public health institutions at the primary health care level, and this data in the period from 2021 to 2025 shows a decreasing trend in the number of prescriptions for antibiotics in public health institutions in Montenegro.
According to data from the Public Health Institute, 750 prescriptions were prescribed in public health institutions last year per thousand inhabitants, while in 2024, 803 prescriptions were prescribed, in 2023, 800, in 2022, 838, while in 2021, 820 prescriptions were prescribed per thousand inhabitants.
Canović: High resistance rates even to antibiotics considered reserve
Doctor of Pharmacy Sanda Canović told the MINA agency that the fact that Montenegro is the leading country in Europe in terms of antibiotic consumption indicates a systemic problem, which is cultural in nature, but also an indicator of insufficient awareness among patients about the importance of saving antibiotics for real needs, when they are necessary.
"Antibiotics have been used in the Balkans for years as a cure-all. Unfortunately, even despite various education programs that emphasize the importance of proper antibiotic use, it often happens that antibiotics are still overused - that is, they are used when they are not needed," said Canović.
She stressed that higher consumption does not mean better treatment. "On the contrary, it means a greater risk to the health of the population due to the development of bacterial resistance."
According to Canović, any improper use of antibiotics, whether they are taken unnecessarily, in the wrong dose, or if therapy is stopped too early, contributes to the development of bacterial resistance.
"This means that over time, bacteria "learn" how to survive the effects of the drug, making available antibiotics less and less effective," Canović said.
According to her, this problem is already very pronounced in Montenegro.
"Certain bacteria are showing high rates of resistance even to antibiotics that are considered reserve, that is, those that should only be used in the most severe cases," said Canović.
As she added, this leads to a situation where infections are more difficult to treat, treatment takes longer, and the risk of complications and death increases.
"Antibiotic resistance is rightly considered one of the biggest threats to modern medicine today," Canović pointed out.
She said that the most common mistakes patients make are using antibiotics for viral infections, using antibiotics they have left over from before without consulting a doctor, stopping therapy early, incorrect dosing, or skipping doses.
"All of this can lead to incomplete healing, recurrence of the infection, and development of resistance," said Canović, adding that the use of antibiotics without the supervision of healthcare professionals can disrupt the intestinal flora and lead to additional complications and the development of fungal infections.
Canović believes that the legal framework in Montenegro clearly defines the dispensing of antibiotics exclusively on the recommendation of a doctor and a prescription, but that there is room for improvement.
"Through additional regulation of the legal framework, additional education of healthcare workers, as well as more intensive information to citizens about the importance of proper use of antibiotics, as well as the risks due to their improper use," Canović stated.
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