Yesmin S M Sabrina, Chakma Paritosh, Habiba Umme, Rhod Larsen Anders, Tino Fusire Terence, Wangmo Sangay, Sarkar Shila, Attauabi Majda
Directorate General of Drug Administration, Aushad Bhavan, Mohakhali, Dhaka 1212, Bangladesh.
World Health Organization Country Office for Bangladesh, Dhaka 1212, Bangladesh.
Antibiotics (Basel). 2025 Aug 28;14(9):868. doi: 10.3390/antibiotics14090868.
This paper provides the first national analysis of antimicrobial use (AMU) of oral and parenteral dosages in Bangladesh, as well as biannual trends for the years from 2019 to 2023. It also analyzes the effect of the COVID-19 pandemic on AMU. AMU was analyzed in accordance with the WHO Anatomical Therapeutic Chemical classification and defined daily doses per 1000 inhabitants per day methodology. Data on antimicrobial medicine dispatched from manufacturers' central warehouse was collected and categorized based on the WHO's Access, Watch, and Reserve (AWaRe) classification. This AMU surveillance demonstrates an increase in the use of antimicrobial medicines from 2021 to 2022, and in 2023, it decreased, with our national AMU surveillance data indicating that cefixime and azithromycin were the most consumed antibiotics during this period. Most antibiotics used in Bangladesh are broad-spectrum 'Watch'-category antibiotics. Among oral antibiotics, 50 to 67% are from the 'Watch'-category. When considering only parenteral antibiotics, 70 to 91 % fall under the 'Watch'-category. Third-generation cephalosporin consumption has been found to be higher than second- and first-generation cephalosporins. The oral antimicrobials are more commonly used than parenteral ones. AMU notably increased during the COVID-19 pandemic, especially in the case of systemic antibacterial use. To achieve the global target of 70% use of Access category antibiotics by 2030, the use of Watch-group antibiotics, like cefixime, azithromycin, ciprofloxacin, levofloxacin, and ceftibuten, needs to be reduced through investing in and strengthening stewardship programs and eliminating self-medication in Bangladesh. The findings of this study provide useful information to policymakers to tackle AMR in Bangladesh.
本文首次对孟加拉国口服和注射用抗菌药物的使用情况进行了全国性分析，并分析了2019年至2023年期间的半年趋势。文章还分析了新冠疫情对抗菌药物使用的影响。抗菌药物使用情况是根据世界卫生组织解剖治疗化学分类法以及每千居民每日限定日剂量方法进行分析的。收集了从制造商中央仓库发出的抗菌药物数据，并根据世界卫生组织的“准入、观察和储备”（AWaRe）分类法进行分类。这项抗菌药物使用监测表明，2021年至2022年抗菌药物的使用有所增加，而在2023年有所下降，我国的抗菌药物使用监测数据表明，在此期间头孢克肟和阿奇霉素是消耗最多的抗生素。孟加拉国使用的大多数抗生素是广谱“观察类”抗生素。在口服抗生素中，50%至67%属于“观察类”。仅考虑注射用抗生素时，70%至91%属于“观察类”。已发现第三代头孢菌素的消耗量高于第二代和第一代头孢菌素。口服抗菌药物比注射用抗菌药物更常用。在新冠疫情期间，抗菌药物的使用显著增加，尤其是全身使用抗菌药物的情况。为实现到2030年70%使用“准入类”抗生素的全球目标，需要通过在孟加拉国投资并加强管理计划以及消除自我用药，来减少“观察类”抗生素（如头孢克肟、阿奇霉素、环丙沙星、左氧氟沙星和头孢布烯）的使用。本研究结果为孟加拉国政策制定者应对抗菌药物耐药性提供了有用信息。
