Pattern of parenteral antibiotic consumption in in-patient units over five years at Teaching Hospital Jaffna

Abstract

Background and objective: Inappropriate use of antibiotics increases the risk of antimicrobial resistance. Data on antibiotic consumption provides basic information for surveillance. This study describes the pattern of parenteral antibiotic consumption in in-patient units at Teaching Hospital Jaffna (THJ) over a period of five years. Methods: It was a retrospective analysis of parenteral antibiotic consumption from 2018 to 2022. Data were extracted from the pharmacy database of THJ. The consumption volume of antibiotics was expressed in defined daily dose (DDD) which was calculated using the Anatomic Therapeutic Classification (ATC)/DDD system of the World Health Organization Collaborating Centre for Drug Statistics Methodology. Inpatient antibiotic consumption was expressed in DDD/100 admissions/ year. The WHO’s AWaRe classification (Access, Watch, Reserve) for antibiotics was used to describe the pattern of antibiotic consumption. One-way ANOVA was performed to determine the significance of changes over a period of time. A p value ≤ 0.05 was considered statistically significant. Results: Almost all parenteral antibiotics (99.3%) were consumed by in-patient units. Proportion of consumption of oral and parenteral antibiotics in in-patient units was 1:1. Consumption of Access, Watch and Reserve groups of parenteral antibiotics were 60.7%, 38.3% and 0.3% respectively, during the five-year period, consistent with WHO recommendations. Penicillin was the most commonly consumed parenteral antibiotic group and amoxicillin+clavulanic acid was the most frequently consumed single antibiotic. Parenteral antibiotic consumption rate was on the decline except in 2020 and 2021 during COVID-19 pandemic, when an increase was observed. An overall decline in the rate of consumption of parenteral antibiotics was observed (from 180.7 to 125.7 DDD/100 admissions between 2018 and 2022). These changes were not statistically significant. Conclusions: Parenteral antibiotic consumption rate at THJ was in line with World Health Organization’s recommendation based on the AWaRe framework.