-Automatic translation

Antimicrobial use in humans

Total sales of antimicrobials for humans were 18.6 defined daily doses per 1,000 inhabitants per day (DID), a 4.6% decrease from the previous year. However, use in Iceland remains higher than in other Nordic countries.

The proportion of antimicrobials considered a desirable first choice (“Access”) for treating infections is high in Iceland, at 81%, compared with other EU/EEA countries. However, the proportion is lower in hospitals than outside them, as hospital-acquired infections are more often caused by resistant pathogens and therefore more frequently require treatment with antimicrobials that should be used sparingly (“Watch” or “Reserve” antimicrobials).

Antimicrobial resistance in humans

Antimicrobial resistance remains generally low in Iceland by European standards, but the emergence of certain resistance types is a cause for concern. The proportion of resistance to third-generation cephalosporins has risen from 4.2% of invasive strains in 2016 to 11.6% of strains in 2025. The development of third-generation cephalosporin resistance in E. coli is a concern, as the estimated incidence of such bloodstream infections has increased from 5.04 per 100,000 inhabitants in 2019 to 10.69 in 2024.

In 2025, 22 individuals were diagnosed with carbapenemase-producing Enterobacterales (CPE), the highest number on record for a single year. Carbapenemase-producing pathogens are among the most resistant bacteria and can be almost completely resistant, while also being common and serious causes of infection.

Antimicrobial use and resistance in animals

Antimicrobial use in animals remains low by international comparison. However, total sales of antimicrobials for animals increased by 21.4% year on year. This increase is explained by continued antimicrobial treatment following an outbreak of furunculosis in land-based Arctic char farming, as well as increased sales of antimicrobials for other animal species. In addition, systematic screening of Icelandic pigs detected livestock-associated MRSA for the first time, and the bacterium was found on four closely related pig farms.

The future

The results underscore the importance of ongoing surveillance, prudent antimicrobial use, and cooperation among public health, animal health, and environmental authorities. The government's action plan against antimicrobial resistance was published in 2024 and outlines the measures Iceland should take to curb the further spread of antimicrobial resistance.

The Chief Epidemiologist