ArticleJAC-antimicrobial resistance2026
Antibacterial consumption in public health facilities in Uganda: a trend analysis of national warehouse distribution data 2022-2024.
Article in JAC-antimicrobial resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Background: While multiple factors contribute to antimicrobial resistance (AMR), the consumption of antimicrobials is a major modifiable cause. Therefore, accurate understanding of antibacterial exposure is critical for effective stewardship. Objective: This study analysed trends of antibacterial distribution data in Uganda between 2022 and 2024. Methods: This was a retrospective cross-sectional study that used data on antimicrobials that were distributed to government-owned health facilities between 2022 and 2024. Data analysis used the WHO Global Antimicrobial Resistance and Use Surveillance System antimicrobial use methodology that uses anatomical therapeutic chemical classification and defined daily doses (DDD) system to classify antimicrobials to estimate antibiotic use volumes. Results: The study revealed an upward trend in antibacterial consumption (ABC) from 2.88 DDD per 1000 inhabitants per day (DID) in 2022 to 10.21 DIDs in 2024. The highest consumption was observed in primary healthcare facilities. The most consumed antibiotics across the three years were penicillin (amoxicillin) (28% in 2022, 24% in 2023 and 37% in 2024) and sulfamethoxazole and trimethoprim (cotrimoxazole) (26% in 2022, 34% in 2023 and 13% in 2024). For the AWaRe classification, antibiotics in Access group (84.1% in 2022, 88.6% in 2023 and 87.0% in 2024) had the largest percentage of DIDs. Conclusions: The study established a marked increase in ABC within Uganda's public sector between 2022 and 2023, followed by a modest rise in 2024. The rise in resistance to commonly used agents could sustain higher demand for some antibiotics. These findings underscore the importance of linking distribution data with facility-level prescribing and resistance patterns to inform stewardship interventions.
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