ArticleJAC-antimicrobial resistance2019
Continuous rise in cephalosporin and fluoroquinolone consumption in Pakistan: a 5 year analysis (2014-18).
Article in JAC-antimicrobial resistance, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Improving antibiotic prescribing in LMICs: Insights from an outpatient clinic in Pakistan.New microbes and new infections · 2026Article
- Longitudinal trends in antibiotic resistance ofPakistan journal of medical sciences · 2025Article
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Pattern of antibiotic dispensing at pharmacies according to access, watch, reserve (AWaRe) classification: multicenter study after COVID-19 waves in different districts of Pakistan.BMC research notes · 2025Article
- Emergence of Extended spectrum β-lactamase (ESBL) and carbapenemase producingPakistan journal of medical sciences · 2025Article
- The Enterics for Global Health (EFGH)Open forum infectious diseases · 2024Article
- A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications.Medicina (Kaunas, Lithuania) · 2023Review
- Distribution of Extended-Spectrum-β-Lactamase-Producing DiarrheagenicAntibiotics (Basel, Switzerland) · 2023Article
- A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2023Article
- Country data on AMR in Pakistan in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome.The Journal of antimicrobial chemotherapy · 2022Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPakistan was third on the list of the highest antibiotic-consuming countries among low- and middle-income countries in 2015. Studies have suggested that areas with higher consumption of antibiotics are likely to have higher antibiotic resistance rates.
objectivesWith limited surveillance data on consumption and resistance in Pakistan, this study investigated the 5 year trends (April 2014 to March 2019) in consumption of the two highest-sold antibiotic classes, cephalosporins [Anatomical Therapeutic Chemical (ATC) group J01D] and fluoroquinolones (ATC group J01MA).
methodsIQVIA Pakistan data (retail) on antibiotic sales presented in units were used. These data were standardized and a DDD was assigned to all formulations, based on WHO's ATC/DDD index, and the data expressed as DIDs (DDDs per 1000 inhabitants per day). WHO's AWaRe classification of antimicrobials was used for the analyses, especially of those categorized as 'Watch'.
resultsThe findings showed a significant increase in consumption trends for 'Watch' cephalosporins (61.5%) while the use of 'Reserve' cephalosporins doubled during the studied period. In 2018, combined consumption of second- and third-generation cephalosporins (both in the 'Watch' group) was nearly five times higher than that of the first-generation cephalosporins. For fluoroquinolones, the total consumption only showed a major increase for ciprofloxacin, with 127 820 more persons per day. The consumption of cephalosporins and fluoroquinolones in Pakistan increased by 1.86 DIDs in just 5 years.
conclusionsIt is urgent to establish a National Antimicrobial Commission in Pakistan, to critically analyse the pharmaceutical market offerings and implement surveillance systems and antimicrobial stewardship.
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Registered trials
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