Antimicrobial Drug Consumption in Ambulatory Care Settings, Tabuk Region, Saudi Arabia

Abstract

Objectives: During the 21 st century, Antimicrobial Resistance (AMR) has emerged as one of the principal public health problems worldwide. In the coming 20 years, health care systems may be incapable to treat bacterial diseases proficiently due to this miracle. We analyzed data from the North West Region Hospitals, Ministry of Health, Saudi Arabia to determine the level of knowledge regarding drug consumption among patients attending five hospitals in ambulatory care settings. Methods: This cross-sectional study was conducted at North West Region Hospitals in Tabuk city, Saudi Arabia for 9 months. The study contestants were selected from different outpatient departments. National Antimicrobial stewardship program highly demand at our country because of poor insight of antibiotics and misappropriation of antibiotics and poor adherence of antibiotics guidelines. Antibiotic consumption is driven from pharmacy database and calculated based on stranded unit of antimicrobial per each hospital. The total cost expenditure of antimicrobial drug consumption was calculated by Ministry of Health National Cost database. The predictable cost expressed in USD. All data and variables analyzed by Microsoft Excel program version 10. Results: The number of antimicrobial drug consumption in ambulatory care settings in the Saudi Arabia were 25,116 i.e. average 5,023.2 per hospital respectively. The highest drug consumption at all ambulatory care visits were azithromycin tablet (10,932), followed by azithromycin syrup (7,760) and moxifloxacin tablet (3218). The overall antimicrobial consumption was 37,620.12 USD and 7,524.02 USD per each hospital. The overall cost medication consumption were adults ambulatory care departments 69.42% (26,114.79 USD), followed by pediatrics ambulatory care departments 24.52% (9,226.018 USD) and neonates ambulatory care departments 6.06% (2,279.32 USD). The highest medication cost was very broad-spectrum antibiotics like Levofloxacin, Linezolid PO IV and Moxifloxacin PO. It disbursed more than 50% of the cost burden. Conclusion: Our results exposed a very high obliviousness of antimicrobial drug consumption and its contributing factors among the study contestants. Ambulatory care settings had a high consumption of antimicrobial drugs with burden cost. Thus, health education and responsiveness are highly and instantly suggested to address antimicrobial drug consumption and related resistances in the Tabuk area at ambulatory care settings. Antimicrobial stewardship program at Ambulatory care clinics is necessary to prevent bugs related resistance, improve patient outcome and avoid unnecessary cost on hospitals in Saudi Arabia.

Systematic Review: Study of the Prescribing Pattern of Antibiotics in Outpatients and Emergency Departments in the Gulf Region

“…Cephalosporins are widely prescribed in outpatient settings in the Gulf region. Overall, 30-40% of all antimicrobials prescribed in the Gulf region are cephalosporins with few exceptions (Senok et al, 2009;John et al, 2014;Al-Balushi et al, 2014;Al Alawi et al, 2015;al Salman et al, 2016;Oqal et al, 2015;Alshakka et al, 2016;Butt et al, 2017;Shaheen et al, 2018;Alanazi, 2018;Almasoudi et al, 2019;Alanazi et al, 2019;Ahmed, 2020c). Highly prescribed cephalosporins are ceftriaxone and cefuroxime.…”

“…A study in Saudi Arabia in 2019 shows high consumption of azithromycin due to the per piece count. Variation is there, but on average, 17-20% of prescribed drugs are macrolides (Senok et al, 2009;John et al, 2014;Al-Balushi et al, 2014;Al Alawi et al, 2015;Al Salman et al, 2016;Oqal et al, 2015;Alshakka et al, 2016;Butt et al, 2017;Shaheen et al, 2018;Alanazi, 2018;Almasoudi et al, 2019;Alanazi et al, 2019). Azithromycin is the most common macrolide prescribed in the Gulf region; others are clarithromycin and erythromycin, and one study shows the prescribing of clindamycin in outpatients.…”

“…studied the antibiotic-prescribing pattern in acute respiratory tract infections in Saudi Arabia and found that cephalosporins (ceftriaxone, first and second generation) were prescribed as 116/515 (22.5%) of all prescriptions Alanazi et al (2018). studied community-acquired urinary tract infections in Saudi Arabia and found that cephalosporines were prescribed for 39% of the total 1,449 patients with UTI Almasoudi et al (2019). studied antimicrobial drug consumption in an ambulatory setting in Saudi Arabia and found that cephalosporins comprised 186/ 25,116 (0.74%) prescriptions as compared to all other antibiotics prescribed in units Alanazi et al (2019).…”

Pediatrics Standardized Concentration of Antibiotics Intravenous Infusion: A New Initiative in Saudi Arabia

“…Antibiotics are widely used locally and internationally. [1][2][3][4] There is a high consumption of antibiotics, which is the Kingdom of Saudi Arabia, especially in adult patients. Besides, antibiotics consumption was high in neonates and pediatrics.…”

“…[1][2][3][4] Parental antibiotics most consumption at critical care and inpatient wards units, while the oral antibiotics are widely used at ambulatory care and emergency services. [1][2][3][4] The most antibiotics consumption was a very broad spectrum with the subsequent high economic burden on the healthcare system. [3,4] The parenteral antibiotics need preparation in multiple diluent solutions and various concentration based on local or international guidelines.…”