Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
(1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patter...
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MDPI AG
2021-04-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/6/2/57 |
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| author | Khin Hnin Pwint Kyaw Soe Min Wenjing Tao Hemant Deepak Shewade Khin Thet Wai Hnin Aye Kyi Sushma Shakya Badri Thapa Rony Zachariah Zaw Than Htun |
| author_facet | Khin Hnin Pwint Kyaw Soe Min Wenjing Tao Hemant Deepak Shewade Khin Thet Wai Hnin Aye Kyi Sushma Shakya Badri Thapa Rony Zachariah Zaw Than Htun |
| author_sort | Khin Hnin Pwint |
| collection | DOAJ |
| description | (1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patterns in total defined daily doses (DDDs). (2) Methods: We followed World Health Organization (WHO) methodology for surveillance of antimicrobial consumption based on hospital antibiotic procurement records (as a proxy). (3) Results: In 32% of all public hospitals where data were retrieved, total antibiotic consumption reduced by 19% between 2014 (7,122,852 DDD) and 2017 (5,794,904 DDD). Consumption per 1000 inhabitants per day (<200 bed hospitals) also reduced from 0.6 to 0.3. Over 60% of procurement was for beta-lactam antibiotics and quinolones; quinolones decreased over time. Consumption of first-line antibiotics increased (42% in 2014 to 54% in 2017), whereas broad-spectrum antibiotics decreased (46% in 2014 to 38% in 2017). Linezolid was the only last-resort antibiotic procured. There was a progressive reduction in per capita government current health expenditure from approximately 9.2 US$ in 2014 to 8.3 US$ in 2017. (4) Conclusions: Antibiotic consumption decreased over time in public hospitals. This first study provides a baseline for developing an antibiotic consumption surveillance system in Myanmar. |
| first_indexed | 2024-03-10T12:09:52Z |
| format | Article |
| id | doaj.art-ac0a613f13d24ec1a285bd22034ec59f |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-10T12:09:52Z |
| publishDate | 2021-04-01 |
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| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-ac0a613f13d24ec1a285bd22034ec59f2023-11-21T16:18:06ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-04-01625710.3390/tropicalmed6020057Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in MyanmarKhin Hnin Pwint0Kyaw Soe Min1Wenjing Tao2Hemant Deepak Shewade3Khin Thet Wai4Hnin Aye Kyi5Sushma Shakya6Badri Thapa7Rony Zachariah8Zaw Than Htun9Department of Medical Research, Ministry of Health and Sports, Yangon 11191, MyanmarDepartment of Medical Services, Ministry of Health and Sports, Naypyidaw 15015, MyanmarUnit for Antibiotics and Infection Control, Public Health Agency of Sweden, 171 65 Stockholm, SwedenInternational Union Against TB and Lungs Disease (The Union), 75000 Paris, FranceDepartment of Medical Research, Ministry of Health and Sports, Yangon 11191, MyanmarDepartment of Medical Services, Ministry of Health and Sports, Naypyidaw 15015, MyanmarWorld Health Organization, Lalitpur 44700, Kathmandu, NepalWorld Health Organization, 403 (A1), Bahan Township, Yangon 11201, MyanmarSpecial Program for Research and Training in Tropical Disease (TDR), 20 Avenue Appia, 1211 Geneva 27, SwitzerlandDepartment of Medical Research, Ministry of Health and Sports, Yangon 11191, Myanmar(1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patterns in total defined daily doses (DDDs). (2) Methods: We followed World Health Organization (WHO) methodology for surveillance of antimicrobial consumption based on hospital antibiotic procurement records (as a proxy). (3) Results: In 32% of all public hospitals where data were retrieved, total antibiotic consumption reduced by 19% between 2014 (7,122,852 DDD) and 2017 (5,794,904 DDD). Consumption per 1000 inhabitants per day (<200 bed hospitals) also reduced from 0.6 to 0.3. Over 60% of procurement was for beta-lactam antibiotics and quinolones; quinolones decreased over time. Consumption of first-line antibiotics increased (42% in 2014 to 54% in 2017), whereas broad-spectrum antibiotics decreased (46% in 2014 to 38% in 2017). Linezolid was the only last-resort antibiotic procured. There was a progressive reduction in per capita government current health expenditure from approximately 9.2 US$ in 2014 to 8.3 US$ in 2017. (4) Conclusions: Antibiotic consumption decreased over time in public hospitals. This first study provides a baseline for developing an antibiotic consumption surveillance system in Myanmar.https://www.mdpi.com/2414-6366/6/2/57operational researchantimicrobial resistanceantibiotic stewardshipAWaReSORT ITsurveillance |
| spellingShingle | Khin Hnin Pwint Kyaw Soe Min Wenjing Tao Hemant Deepak Shewade Khin Thet Wai Hnin Aye Kyi Sushma Shakya Badri Thapa Rony Zachariah Zaw Than Htun Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar Tropical Medicine and Infectious Disease operational research antimicrobial resistance antibiotic stewardship AWaRe SORT IT surveillance |
| title | Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar |
| title_full | Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar |
| title_fullStr | Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar |
| title_full_unstemmed | Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar |
| title_short | Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar |
| title_sort | decreasing trends in antibiotic consumption in public hospitals from 2014 to 2017 following the decentralization of drug procurement in myanmar |
| topic | operational research antimicrobial resistance antibiotic stewardship AWaRe SORT IT surveillance |
| url | https://www.mdpi.com/2414-6366/6/2/57 |
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