Original Research

Antibiotic procurement and ABC analysis for a comprehensive primary health care clinic in the Eastern Cape province, South Africa

Samridhi Sharma, Roman Tandlich, Mohamed Docrat, Sunitha Srinivas
Southern African Journal of Infectious Diseases | Vol 35, No 1 | a134 | DOI: https://doi.org/10.4102/sajid.v35i1.134 | © 2020 Samridhi Sharma, Roman Tandlich, Mohamed Docrat, Sunitha Srinivas | This work is licensed under CC Attribution 4.0
Submitted: 30 May 2019 | Published: 25 November 2020

About the author(s)

Samridhi Sharma, Division of Pharmacy Practice, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
Roman Tandlich, Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
Mohamed Docrat, Eastern Cape Department of Health, Grahamstown, South Africa
Sunitha Srinivas, Division of Pharmacy Practice, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa


Share this article

Bookmark and Share

Abstract

Background: Antimicrobial resistance (AMR), a major threat to global public health, can be addressed using a managed care approach. This includes timely analysis of antibiotic consumption and procurement data to drive evidence-based policies and practices in healthcare facilities. ‘ABC analysis’ presents an opportunity for this.

Methods: ABC analysis data for a comprehensive Primary Health Care (PHC) clinic in the Eastern Cape province of South Africa was obtained from the Provincial Department of Health for 01 April 2015 to 31 March 2018. Procured antibiotics were analysed on the quantities purchased, total cost, route of administration and spectrum of activity. Antibiotic categorization was also carried out according to the World Health Organization Model List of Essential Medicines (WHO EML) 2017.

Results: Antibiotics made up approximately 7% of the total annual pharmaceutical expenditure. A total of 31, 35 and 34 antibiotics were procured in the first, second and third years, respectively. The most procured antibiotics were: (1) isoniazid, (2) flucloxacillin, (3) azithromycin, (4) a combination of rifampicin, isoniazid, pyrazinamide, and ethambutol and (5) amoxicillin. Overall, 55%, 2% and 15% of antibiotics accounted for the ‘Access’, ‘Watch’ and ‘Access and Watch’ categories, respectively, of the WHO EML. No ‘Reserve’ antibiotics were procured. The remaining 28% were antituberculosis medicines. Altogether, 89%, 8% and 3% of the antibiotics were respectively administered orally, systemically, and topically. A total of 58% were broad-spectrum and 42% were narrow-spectrum antibiotics.

Conclusion: Oral antibiotics in the ‘Access’ category presented favourable usage of antibiotics. Decreasing the use of broad-spectrum antibiotics requires consideration.


Keywords

antibiotics; antimicrobial resistance; ABC analysis; Essential Medicines List; expenditure; primary health care; procurement; South Africa.

Metrics

Total abstract views: 392
Total article views: 193


Crossref Citations

No related citations found.