Abstract

The purpose of this study is to conduct a comparative analysis of the consumption of antibiotics for systemic use reimbursed by the state in Kazakhstan for 2017–2019 with the Access, Watch, and Reserve classification (AWaRe 2019) of the World Health Organization (WHO). The evaluation of the consumption of antibiotics for systemic use in Kazakhstan for 2017–2019 was carried out using the ATC/DDD methodology in accordance with the WHO AWaRe classification. The study used data on all antibiotics that were centrally purchased by a single purchaser during the study period. To understand how often Access group antibiotics are taken in Kazakhstan, the top-10 most consumed antibiotics were additionally studied. The results of a comparative analysis of the antibiotics for systemic use consumption for 2017–2019 by the Access, Watch, and Reserve groups showed a negative trend of a decrease in the consumption of Access group drugs from 1.17 defined daily dose (DDDs) per 1000 inhabitants per day (DID) (39%) in 2017 to 0.59 DID (30%) in 2019. There is an increase in consumption of Watch group antibiotics from 1.84 DID (61%) in 2017 to 1.37 DID (68%) in 2019, as well as an increase in consumption of Reserve antibiotics from 0.001 DID (0.03%) to 0.4 DID (2.11%). In recent years in Kazakhstan, there has been a decrease in the consumption of Access group antibiotics. In addition, the Watch group antibiotics are widely consumed with a certain upward trend. In 2019, one Reserve antibiotic was included in the top-10 most commonly consumed antibiotics. There is a predominant consumption of parenteral forms of antibiotics for systemic use in the country.

Highlights

  • Antimicrobial resistance (AMR) is a global problem of public healthcare that comes with huge social and economic losses due to infectious diseases

  • This study aims to conduct a comparative analysis of the consumption of antimicrobials for systemic use reimbursed by the state in Kazakhstan for 2017–2019 with the World Health Organization (WHO) AWaRe classification

  • The results of our study showed a disturbing picture of the irrational consumption of antibiotics of systemic effect in Kazakhstan

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Summary

Introduction

Antimicrobial resistance (AMR) is a global problem of public healthcare that comes with huge social and economic losses due to infectious diseases. The potential for widespread use of antimicrobials in medical practice could lead to long-term increases in AMR mortality rates. To optimize the rational use of antibiotics and support monitoring, in March 2017, the WHO introduced a detailed classification of antibiotics, which was designated Access, Watch, and Reserve [1,2]. This classification includes information about 180 antibiotics classified as Access, Watch, and Reserve and pharmacological classes, anatomical— therapeutic classification codes, and status in Essential Medicines List (EML) WHO. WHO’s 13th General Programme of Work (GPW 13) requires at least 60% of Access antibiotics to be consumed to achieve health-related sustainable development targets [2]

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