Evaluating consumption and expenditure patterns of antibiotics in tablet and capsule dosage forms: Pakistan Antibiotic Consumption Surveillance (PACS)

Abstract

AbstractBackgroundAntibiotics are available in the marketplace in the form of tablets and capsules, and are mostly self‐prescribed by patients, with the consequent emergence of antimicrobial resistance (AMR). This study evaluated the consumption patterns of antimicrobials in these dosage forms during 2017 in Pakistan.MethodsData were acquired retrospectively from the International Medical Statistics (IMS) survey, Pakistan. Only the dosage forms of tablets and capsules constituting four major classes of antibiotics were included in the present study. Antibiotic consumption was measured using the World Health Organization's Anatomical Therapeutic Chemical Classification System with Daily Defined Doses (ATC/DDD) methodology. In addition, we calculated the DID as the total DDDs of antibiotic consumed in a defined period in that area per 1000 people. Expenditure was measured in Pakistan rupees (PKR) and converted to US dollars.ResultsTotal consumption of tablet and capsule dosage forms of antibiotics was found to be 10.6 DID, whereas total expenditure was US$221.5 million (26.69 billion PKR). Of all antibiotics, the most widely consumed were co‐amoxiclav (1.89 DID), levofloxacin (DID 1.41), ciprofloxacin (DID 1.38) and amoxicillin (DID 1.32). The top class of antibiotics based on expenditure was fluoroquinolones (ATC code J01MA), followed by combinations of penicillins (J01CR), third‐generation cephalosporins (J01DD) and macrolides (J01FA).ConclusionsExcessive consumption of broad‐spectrum and clinically important classes of antibiotics was observed. The study findings can serve as baseline data for policy makers and authorities to shape and design policies for the rational and cost‐effective use of antibiotics, reducing the burden of AMR and ensuring the economic use of antibiotics.