Antimicrobial Consumption in Latin American Countries: First Steps of a Long Road Ahead

Marín, Gustavo Horacio; Giangreco, Lucia; Dorati, Cristian; Mordujovich, Perla; Boni, Silvia; Mantilla-Ponte, Hilda; Arvez, Ma José Alfonso; López-Peña, Mónica; González, Ma Francisca Aldunate; Fung, Shing Mi Ching; Barcelona, Laura; Campaña, Laura; Orellana, Alejandra Vaquero; Rodríguez, Tatiana Orjuela; Cantero, Larissa Ginés; Villar, Rosa A; Fuentes, Nicole Sandoval; Melero, Emiliano; Marín-Piva, Hugo; Soler, Gisela; Gabriel, Fernanda Sousa; Velandia, Laura Pineda; Florentín, Cinthia Ojeda; Patron, Soledad Risso; Rivas, Mariela Ortiz; Benítez, Carolina Mendoza; Mellado, Rosemarie; Ivanovska, Verica; Müller, A.; Rojas, Robin; Castro, José L.

doi:10.1177/21501319221082346

Cited by 13 publications

(11 citation statements)

References 15 publications

(19 reference statements)

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“…This will be particularly useful in Trinidad and Tobago, where there is a paucity of data on this topic and the traditional manner of data collection from the public sector potentially grossly underestimates the actual magnitude of the problem [ 13 ]. This pattern is evident in most developing countries, and the implementation of the system in this study may serve as a template for the implementation of similar programs in countries with similar challenges and for primary care and even secondary and tertiary care [ 27 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 96%

Antimicrobial Consumption from 2017 to 2021 in East Trinidad and Tobago: A Study in the English-Speaking Caribbean

Nagassar¹,

Jalim

Mitchell³

et al. 2023

Antibiotics

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An antimicrobial consumption (AMC) study was performed in Trinidad and Tobago at the Eastern Regional Health Authority (ERHA). A retrospective, cross-sectional survey was conducted from 1 November 2021 to 30 March 2022. Dosage and package types of amoxicillin, azithromycin, co-amoxiclav, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, nitrofurantoin and co-trimoxazole were investigated. Consumption was measured using the World Health Organization’s Antimicrobial Resistance and Consumption Surveillance System methodology version 1.0, as defined daily doses (DDD) per 1000 population per day (DID). They were also analyzed using the ‘Access’, ‘Watch’ and ‘Reserve’ classifications. In the ERHA, AMC ranged from 6.9 DID to 4.6 DID. With regards to intravenous formulations, the ‘Watch’ group displayed increased consumption, from 0.160 DID in 2017 to 0.238 DID in 2019, followed by a subsequent drop in consumption with the onset of the COVID-19 pandemic. Oral co-amoxiclav, oral cefuroxime, oral azithromycin and oral co-trimoxazole were the most highly consumed antibiotics. The hospital started off as the higher consumer of antibiotics, but this changed to the community. The consumption of ‘Watch’ group antibiotics increased from 2017 to 2021, with a drop in consumption of ‘Access’ antibiotics and at the onset of COVID-19. Consumption of oral azithromycin was higher in 2021 than 2020.

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Section: Discussionmentioning

confidence: 96%

Antimicrobial Consumption from 2017 to 2021 in East Trinidad and Tobago: A Study in the English-Speaking Caribbean

Nagassar¹,

Jalim

Mitchell³

et al. 2023

Antibiotics

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“…The temporal analysis of antibiotic consumption and gross expenditure shown in Table 3, within LHANS, reveals notable changes in the utilization of specific antibiotics and associated costs. Increases in the usage of certain antibiotics suggest a potential need for monitoring their appropriate use to prevent overprescribing and minimize the risk of antibiotic resistance [40,42]. Conversely, reductions in the consumption of other antibiotics may be indicative of evolving treatment guidelines or the availability of alternative treatment options.…”

Section: Comparison Of Antibacterial Drug Expenditure and Consumptionmentioning

confidence: 99%

“…Conversely, reductions in the consumption of other antibiotics may be indicative of evolving treatment guidelines or the availability of alternative treatment options. As mentioned, the mixed pattern of changes in gross expenditure emphasizes the dynamic nature of healthcare costs, influenced by factors such as drug pricing, prescribing practices, and healthcare policies within the country [38,[41][42][43].…”

Section: Comparison Of Antibacterial Drug Expenditure and Consumptionmentioning

confidence: 99%

Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis

Zavaleta‐Monestel¹,

Ferrara²,

Zovi³

et al. 2023

Cureus

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Background and objective: The increasing emergence and spread of drug-resistant pathogens resulting from inappropriate antibiotic usage have become more evident in recent years, particularly with the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Since joining the Organization for Economic Cooperation and Development (OECD), Costa Rica can now compare its healthcare system with other countries, and similarities have been noted with Italy regarding health indicators. Both nations have universal healthcare systems, covering their entire populations, and hold similar positions in the Human Development Index (HDI). Consequently, the goal is to compare antibiotic prescribing and consumption patterns to collaboratively develop strategies against bacterial resistance. Methods: In order to compare antibiotic consumption between regions, a standardized contrast was utilized, specifically using the Defined Daily Dose (DDD). An Orthogonal Contrast test was performed to test the means, followed by the application of the Student's t-test on these contrasts. This analysis aimed to assess the potential influence of regions on DDD values. Antibiotic consumption data were collected between January 2021 and December 2022 from the Local Health Authority of Naples 3 South (LHANS) in Italy and IQVIA reports in Costa Rica.Results: LHANS shows a considerable disparity in gross expenditure compared to Italy's overall expenditure, while the private sector in Costa Rica exhibits even lower gross expenditure than Italy. Antibiotic consumption in Italy exceeds that of Costa Rica, with Costa Rica's consumption amounting to 47.70% of Italy's total consumption. Additionally, LHANS exhibited a 22.43% higher gross expenditure compared to the Campania region, emphasizing the variability in antibiotic usage within the same country The results indicated no statistically significant differences in antibiotic consumption between the regions, as none of the null hypotheses were rejected. Conclusions:The study provides valuable insights into expenditure patterns and antibiotic consumption, highlighting the need for improved prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings emphasize the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.

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“…The country reported a total antimicrobial consumption of 18 DDD/1 000 inhabitants per day, corresponding to three ATC codes described as essential antimicrobial medicines: J01 (antibacterials for systemic use), P01AB (nitroimidazole derivatives, for diseases caused by protozoa), and A07AA (intestinal antibacterials). The predominant antibiotics were beta-lactams/penicillin (6%–35%), macrolides/lincosamides (3%–17%), and quinolones (2%–13%) ( 7 ).…”

mentioning

confidence: 99%

“…While the national DDD indicator was comparable to other Latin American countries (Argentina, Chile, Costa Rica, Paraguay, and Peru), the share of macrolides and quinolones was notably higher in Colombia than elsewhere. The intake of these last two antibiotic classes was the highest among the countries involved in the study ( 7 ). When analyzed using the WHO AWaRe 3 antimicrobial classification, 70% of the antimicrobials consumed belonged to the “Access” category, 29% to the “Watch” category, and 0.12% were “Reserve” antimicrobials.…”

mentioning

confidence: 99%

Antibiotic consumption in secondary and tertiary hospitals in Colombia: national surveillance from 2018–2020

Lopez

Martínez

Bustos³

et al. 2023

Revista Panamericana De Salud Pública

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Objective. To assess the compliance in secondary and tertiary level hospitals with monthly reporting of antibiotic consumption to the Colombian National Public Health Surveillance System (SIVIGILA-INS), and to describe reported antibiotic consumption during 2018–2020. Methods. This study involved a secondary analysis of antibiotic consumption data reported to SIVIGILA-INS. Frequency of hospital reporting was assessed and compared against expected reports, disaggregated by intensive care units (ICU)/non-ICU wards and geographical regions. Consumption was expressed as defined daily dose (DDD) per 100 occupied beds for seven antibiotics. Results. More than 70% of hospitals reported antibiotic consumption at least once in each of the three years (79% in ICU and 71% in non-ICU wards). Of these, ICU monthly reporting was complete (12 monthly reports per year) for 59% in the period 2018–2019 but only 4% in 2020. Non-ICU reporting was complete for 52% in 2019 and for 2% in 2020. Most regions had an overall decrease in reporting in 2020. Analysis of antibiotic consumption showed an increase for piperacillin/tazobactam, ertapenem, and cefepime from 2019 to 2020. Conclusions. There were gaps in the consistency and frequency of reporting. Efforts are needed to improve compliance with monthly reporting, which declined in 2020, possibly due to the COVID-19 pandemic. Non-compliance on reporting and data quality issues should be addressed with the hospitals to enable valid interpretation of antibiotic consumption trends.

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Antimicrobial Consumption in Latin American Countries: First Steps of a Long Road Ahead

Cited by 13 publications

References 15 publications

Antimicrobial Consumption from 2017 to 2021 in East Trinidad and Tobago: A Study in the English-Speaking Caribbean

Antimicrobial Consumption from 2017 to 2021 in East Trinidad and Tobago: A Study in the English-Speaking Caribbean

Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis

Antibiotic consumption in secondary and tertiary hospitals in Colombia: national surveillance from 2018–2020

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