Original Research

Antibiotic consumption in the public sector of the Limpopo province, South Africa, 2014–2018

Tiyani C. Mthombeni, Johanita R. Burger, Martha S. Lubbe, Marlene Julyan
Southern African Journal of Infectious Diseases | Vol 37, No 1 | a462 | DOI: https://doi.org/10.4102/sajid.v37i1.462 | © 2022 Tiyani C. Mthombeni, Johanita R. Burger, Martha S. Lubbe, Marlene Julyan | This work is licensed under CC Attribution 4.0
Submitted: 27 June 2022 | Published: 25 October 2022

About the author(s)

Tiyani C. Mthombeni, Department of Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Johanita R. Burger, Department of Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Martha S. Lubbe, Department of Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Marlene Julyan, Department of Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa

Abstract

Background: Antibiotic consumption (ABC) surveillance is a critical component of the strategic priority response to the increasing antibiotic resistance threat. Levels of ABC at the national and provincial levels in South Africa are unknown because of inadequate ABC surveillance systems and literature. Antibiotic consumption in the public sector of Limpopo province, South Africa, 2014-2018

Methods: This retrospective study used sales data retrieved from a pharmaceutical warehouse distribution database to quantify ABC. Antibiotic consumption was measured by the defined daily dose (DDD) per 1000 inhabitants per day (DID) and 75% drug utilisation index (DU75%). Change in consumption was measured by the compound annual growth rate (CAGR).

Results: Between 2014 and 2018, the mean ABC was 4.6 ± 1.0 DID, with an overall decrease of 1.6% in the CAGR. Penicillins (2.3 ± 0.8; 50.0%), sulphonamide and trimethoprim combinations (1.4 ± 0.3 DID; 30.4%) were the most consumed antibiotics. Macrolides had the highest relative increase in consumption during the study period, with a CAGR of 18.5%. In contrast, tetracyclines had the highest relative decrease in consumption, with a CAGR of 100.0%. The CAGR ratio for broad- to narrow-spectrum increased by 39.3%, from 0.4 in 2014 to 2.1 in 2018. The DU75% comprised amoxicillin (28.4%), sulphamethoxazole and trimethoprim (SMX-TMP) (27.2%), doxycycline (12.3%) and azithromycin (9.2%).

Conclusion: While ABC remained relatively stable throughout the study, there was an increase in broad-spectrum ABC that requires further investigation.

Contribution: This study contributes ABC surveillance data in Southern Africa, described by ATC classification, which is essential for monitoring and evaluating antibiotic stewardship programmes.

 


Keywords

pharmaceutical sales data; antibiotic consumption; antibiotic utilisation; Anatomical Therapeutic Chemical; defined daily dose; ATC DDD per 1000 inhabitants per day; 75% drug utilisation index; Limpopo; South Africa

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