ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Regional and National Trends in Consumption of Antimicrobials in Pakistan; Pre and Post-COVID (2019-2021).
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Twelve years of genomic surveillance of vancomycin-resistant Enterococcus faecium: emergence of linear vanA and bacteriocin-carrying plasmids challenging infection control.Genome medicine · 2026Article
- Trends in Antimicrobial Consumption in Pakistan (2016-2028): Retrospective Observational Study With Forecasting.JMIR public health and surveillance · 2026Observational
- Dramatic increase in consumption of antibiotics in Colombia, 2020-2023Biomedica : revista del Instituto Nacional de Salud · 2026Article
- Addressing Antimicrobial Resistance: A Point Prevalence Survey Using AWaRe Indicators from Outpatient Settings of Multan, Pakistan.Infection and drug resistance · 2026Article
- Development, implementation, and usability evaluation of an mHealth-based clinical decision-support system for strengthening antimicrobial stewardship among physicians in Pakistan: a mixed-methods study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Patients and Surfaces: Integrated Clinical-Environmental Surveillance of MDR Gram-Negative Bacteria in Critical-Care Units (Karachi, 2024-2025).Microorganisms · 2025Article
- Unequal budgeting and limited WHO AWaRe Access antibiotics in Punjab: procurement policy gaps in Pakistan's National Action Plan against antimicrobial resistance.Archives of public health = Archives belges de sante publique · 2025Article
- Multiple highly resistant clones of MRSA circulating among patients with skin and soft tissue infection, Peshawar, Pakistan 2021-2022.Epidemiology and infection · 2025Article
- Evaluating anti-MRSA antibiotic stewardship with a focus on trends in consumption and resistance in a tertiary hospital in Alexandria, Egypt from 2019 to 2023.Archives of public health = Archives belges de sante publique · 2025Article
- The healthy human gut can take it all: vancomycin-variable, linezolid-resistant strains and specific bacteriocin-species interplay inApplied and environmental microbiology · 2025Article
- National antibiotic consumption for human use in Chad (2017-2021): a descriptive cross-sectional study.Frontiers in antibiotics · 2025Article
- Paediatricians' knowledge, perceptions, preparedness and involvement towards paediatric antimicrobial stewardship in Pakistan: findings and the implications.JAC-antimicrobial resistance · 2024Article
- The Assessment and Efficiency of Cefixime in Upper Respiratory Tract Infections: Insights and Perspectives.Cureus · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
Abstract
backgroundEfforts to combat antimicrobial resistance, a growing public health problem in Pakistan, have been hampered by the lack of high-quality national and provincial-level antimicrobial consumption data. The singular objective of this retrospective study was to measure antimicrobial consumption over 3 years between 2019 and 2021.
methodsThe study was designed to estimate antimicrobial consumption at National and Regional levels. Antimicrobial consumption data was collected by IQVIA covering 110 districts of Pakistan in which 88% of sales are census (accurate sales collected directly from distributors), whereas 12% of sales (sales of 300 pharmacies) are projected on the national level. To determine the usage for 3 consecutive years, the consumption of antibiotics was calculated as defined daily doses (DDD) of antibiotics per 1000 inhabitants per day (DID).
resultsThe results of our study demonstrated a steep increase in the consumption of antimicrobials from 2019 to 2021. An increase in consumption of most classes of antibiotics was observed both nationally and Regionally. Quinolones, penicillins (co-amoxiclav), macrolides, and third-generation cephalosporins remained the most frequently used antibiotics nationally. A 40% increase in intravenous use of antimicrobials was observed between 2019 and 2021 at the national level. Moxifloxacin, Levofloxacin, Ciprofloxacin, and linezolid were the most commonly used intravenous antibiotics. Region 7 (Peshawar) demonstrated the highest consumption, followed by Region 1 (Karachi) and Region 6 (Faisalabad). Among the most commonly used antibiotics, the use of third-generation cephalosporin (cefixime), quinolones, penicillins (amoxicillin + clavulanic acid), and macrolides (azithromycin) was most noticeable in all regions, particularly in those with the higher consumption of antibiotics.
conclusionsAlthough the increase in consumption of all antibiotics is concerning, the steep increase in the use of watch and reserve category antibiotics during the study period calls for immediate actions to limit and regulate their usage.
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