Portugal’s High Antibiotic Use Puts Residents at Greater Risk of Superbugs

Respiratory infections may feel inevitable once the first cold winds arrive, yet the way Portugal reaches for antibiotics continues to raise alarms. New figures show that while dispensing has slowed slightly in 2025, the country still sits above the European average, challenging national promises to curb antimicrobial resistance before the decade closes.

Where Portugal Stands Now

Even after two successive influenza seasons, community pharmacies are handing out roughly 18.8 daily doses per 1,000 residents—a touch below last year’s 19, but still higher than the 2019 baseline regulators use for comparison. The absolute volume remains striking: by October, counters had already moved more than 7.1 million packs, and trends suggest another winter rush. Hospital wards tell a similar story, edging up to 1.8 DHD and holding there through mid-2025. Those numbers leave Portugal with an overall increase of 8 % since 2019, quadruple the EU’s average growth.

Why Brussels Is Watching

The European Council’s 2023 recommendation announced a continent-wide ambition to cut human antibiotic use by 20 % by 2030. Lisbon negotiated a softer 9 % target, arguing that drastic reductions risk under-treating genuine bacterial infections. Still, the latest surveillance bulletin from the ECDC situates Portuguese consumption well above peers such as Germany or the Netherlands and uncomfortably close to heavy-use countries in Southern and Eastern Europe. Public-health specialists warn that this position, combined with Portugal’s high rates of carbapenem-resistant Klebsiella pneumoniae, could undermine the Schengen region’s broader containment efforts.

The Drugs Drawing Most Concern

Regulators single out quinolones and carbapenems—powerful agents often reserved for complicated cases. Community quinolone use hovered at 1.3 DHD for two years before ticking up to 1.4 in early 2025. Carbapenems, employed almost exclusively in hospitals, stay stable at 0.10 DHD yet remain pivotal because resistant strains rapidly shut down therapeutic options. Health-economy models forecast that unchecked resistance could cost Portugal €300 million a year in additional hospital stays and productivity losses by 2030.

National Toolbox: Promises and Pitfalls

Authorities point to a multi-layered response. The PPCIRA network obliges every public hospital to run antimicrobial stewardship teams that review prescriptions in real time. Infarmed’s digital dashboards now publish monthly heat maps of consumption, allowing family doctors to compare their own habits against district averages. November’s nationwide media blitz—“O poder dos antibióticos depende de todos nós”—urges citizens to finish treatments only when prescribed and never demand antibiotics for viral colds. Early feedback from the pharmaceutical society describes the campaign as the most visible since the H1N1 flu outbreak, yet dispensing data suggest behaviour change is incremental at best.

Voices From the Front Line

Clinicians in Porto and Évora report that patient expectations remain the hardest barrier. Paediatrician Marta Ribeiro notes that parents still arrive expecting a prescription "just in case" after a single night of fever. Meanwhile, microbiologist João Caldeira praises tighter hospital protocols but warns that community overuse "will keep fuelling resistant imports into the wards". Both agree that health-literacy efforts must move beyond slogans and into sustained school curricula and workplace training.

What It Means for Residents

For most people, the immediate takeaway is simple: antibiotics are losing power faster than they are being discovered. Sticking to medical advice, completing courses exactly as directed, and never stockpiling leftover pills are small individual choices that collectively determine whether Portugal meets its 2030 goal—or whether superbugs claim a larger human and economic toll. The winter season has only just begun; what happens at the pharmacy counter over the next few months will shape the statistics in next year’s report and, more importantly, the effectiveness of life-saving drugs for years to come.