Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Jayewardenepura, Sri Lanka.
PLoS One. 2021 Sep 14;16(9):e0257424. doi: 10.1371/journal.pone.0257424. eCollection 2021.
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.
To quantify and describe the national ABC in Sri Lanka and to examine any differences in the consumption between public and private sector.
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.
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.
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.
优化抗菌药物的使用是对抗抗菌耐药性的一种公认策略。可靠的抗菌药物消耗（ABC）数据的可用性是实施这一策略的前提。
量化和描述斯里兰卡的国家 ABC，并检查公共和私营部门之间的消耗差异。
本调查的方法是从世界卫生组织（WHO）的全球抗菌药物消耗监测计划中改编而来。2017 年系统抗菌药物（J01-解剖治疗化学分类（ATC）的国家消耗总量数据从所有现有数据来源中回顾性提取，并使用 ATC 分类进行分类。消耗的数量转换为限定日剂量（DDD）。数据以总消耗量和公共与私营部门之间的比较呈现。对这两个部门的 ABC 关键质量指标进行了比较。
从现有数据源中，2017 年的总 ABC 为 3.4346 亿 DDD。私营部门的消耗量为 2.4676 亿 DDD，而卫生部向整个公共部门分发的消耗量为 0.9796 亿 DDD。公共部门的β-内酰胺-青霉素类抗菌药物组占 58.79%，而私营部门则占 27.48%；而私营部门的大环内酯类、喹诺酮类和其他β-内酰胺类抗菌药物占 60.51%，而公共部门则占 28.41%。储备类抗菌药物的消耗微不足道，仅限于私营部门。观察类抗菌药物分别占总消耗、公共消耗和私营消耗的 46%、24%和 54%。
在私营部门观察到广谱和观察类抗菌药物的使用不成比例地增加，这需要进一步研究。这项国家消耗调查突出了在斯里兰卡建立 ABC 监测的必要性和提供了机会。
