Antibiotic Consumption in the State Sector of Sri Lanka Over 25 Years: 1994 - 2018 Using the GAP Methodology

Fernandopulle, B. M. R.; Yasarathna, K. W. G. K. P.; Gunasekara, Agampodi Danushi M.; Wijesinghe, K. G. C. D. B.; Beneragama, B. V. S. H.; Panapitiya, L.; Wanniarachchi, L. C.; Ranganathan, Shalini Sri

doi:10.4038/pjsl.v10i1.57

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“…While national data on ABR patterns are available in Sri Lanka [ 24 , 25 ], to the best of our knowledge this is the first attempt at obtaining national antibacterial consumption data. Previous data from Sri Lanka which have been included in other surveys [ 6 , 19 , 20 ] have been obtained from either only pharmaceutical sales [ 6 , 19 ] data or only public sector ABC data [ 20 ]. Adopting WHOs’ standard methodology made it possible for us to compare our findings with similar studies done globally and in the region.…”

Section: Resultsmentioning

confidence: 99%

“…The available AMR data shows significant resistance by bacteria causing common infections to 1 st line antibacterials [ 16 – 18 ]. Available AMC data from Sri Lanka are either limited to pharmaceutical sales data which lacks information of the public sector ABC [ 6 , 19 ] or only from the public sector and lacks information about consumption in the private sector [ 20 ]. The public sector data showed an increase of ABC by 143% (44.4–108.2 million DDDs) with a significant shift towards the use of broad-spectrum antibacterials from 1998 to 2018 [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Available AMC data from Sri Lanka are either limited to pharmaceutical sales data which lacks information of the public sector ABC [ 6 , 19 ] or only from the public sector and lacks information about consumption in the private sector [ 20 ]. The public sector data showed an increase of ABC by 143% (44.4–108.2 million DDDs) with a significant shift towards the use of broad-spectrum antibacterials from 1998 to 2018 [ 20 ]. There is, however, no system at present to correlate AMC/ABC data with AMR/ABR patterns in the country.…”

Section: Introductionmentioning

confidence: 99%

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A national survey of antibacterial consumption in Sri Lanka

et al. 2021

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Introduction Optimizing the use of antibacterial medicines is an accepted strategy to combat the antibacterial resistance. Availability of reliable antibacterial consumption (ABC) data is a prerequisite to implement this strategy. Objectives To quantify and describe the national ABC in Sri Lanka and to examine any differences in the consumption between public and private sector. Methods The methodology for this survey was adapted from World Health Organization (WHO) methodology for a global programme on surveillance of antimicrobial consumption. Aggregate data on national consumption of systemic antibacterials (J01- Anatomical Therapeutic Chemical Classification (ATC) for 2017 were retrospectively extracted from all available data sources and classified using ATC classification. Quantity of consumption was converted to Defined Daily Doses (DDDs). Data are presented as total consumption and comparison between the public and private sector. Selected key quality indicators of ABC were compared between these two sectors. Findings From the available data sources, the total ABC in 2017 was 343.46 million DDDs. Private sector consumption accounted for 246.76 million DDDs compared to 97.96 million DDDs distributed to entire public sector by the Ministry of Health. Beta-lactam-penicillins antibacterial group accounted for 58.79% in public sector compared to 27.48% in private sector while macrolides, quinolones and other beta-lactam antibacterials accounted for 60.51% in the private compared to 28.41% in public sector. Consumption of Reserve group antibacterials was negligible, and limited to private sector. Watch category antibacterials accounted for 46%, 24% and 54% of the total, public and private sector consumption, respectively. Conclusions A disproportionately higher use of broad spectrum and Watch category antibacterials was observed in the private sector which needs further study. This national consumption survey highlights the need and provides the opening for establishment of ABC surveillance in Sri Lanka.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A national survey of antibacterial consumption in Sri Lanka

et al. 2021

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A Review of the Dissemination of Antibiotic Resistance through Wastewater Treatment Plants: Current Situation in Sri Lanka and Future Perspectives

Gunawardana,

Kalupahana,

Kottawatta

et al. 2024

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The emergence of antibiotic resistance (AR) poses a significant threat to both public health and aquatic ecosystems. Wastewater treatment plants (WWTPs) have been identified as potential hotspots for disseminating AR in the environment. However, only a limited number of studies have been conducted on AR dissemination through WWTPs in Sri Lanka. To address this knowledge gap in AR dissemination through WWTP operations in Sri Lanka, we critically examined the global situation of WWTPs as hotspots for transmitting antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) by evaluating more than a hundred peer-reviewed international publications and available national publications. Our findings discuss the current state of operating WWTPs in the country and highlight the research needed in controlling AR dissemination. The results revealed that the impact of different wastewater types, such as clinical, veterinary, domestic, and industrial, on the dissemination of AR has not been extensively studied in Sri Lanka; furthermore, the effectiveness of various wastewater treatment techniques in removing ARGs requires further investigation to improve the technologies. Furthermore, existing studies have not explored deeply enough the potential public health and ecological risks posed by AR dissemination through WWTPs.

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Antibiotic Consumption in the State Sector of Sri Lanka Over 25 Years: 1994 - 2018 Using the GAP Methodology

Cited by 2 publications

References 1 publication

A national survey of antibacterial consumption in Sri Lanka

A national survey of antibacterial consumption in Sri Lanka

A Review of the Dissemination of Antibiotic Resistance through Wastewater Treatment Plants: Current Situation in Sri Lanka and Future Perspectives

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