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Trends in antimicrobial consumption in Bhutan.

Thupten Tshering1, Sonam Wangda2, Kirsty Buising3

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Summary

Antimicrobial consumption in Bhutanese healthcare facilities increased from 2017 to 2019, though it remains lower than European averages. Penicillin-based antibiotics were most frequently used, highlighting the need for monitoring and optimization strategies.

Keywords:
Antimicrobial consumptionAntimicrobial resistanceDefined daily dosebroad-sepectrum antibioticsurveillancetrends

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Pharmacovigilance

Background:

  • Antimicrobial resistance is a significant global health threat driven by antimicrobial use.
  • Monitoring antimicrobial consumption is crucial for combating resistance.
  • Understanding national antimicrobial consumption patterns is essential for targeted interventions.

Purpose of the Study:

  • To determine antimicrobial consumption in Bhutan using defined daily doses (DDDs) per 1000 inhabitants per day (DIDs).
  • To analyze antimicrobial consumption trends at national and dzongkhag levels from 2017 to 2019.
  • To compare Bhutan's antimicrobial consumption with international benchmarks.

Main Methods:

  • Retrospective analysis of national medicine distribution records from 2017 to 2019.
  • Utilized the World Health Organization Anatomical Therapeutic Chemical (ATC) Classification System and DDD methodology.
  • Calculated antimicrobial consumption in DIDs for systemic use (ATC subgroup J01).

Main Results:

  • Antimicrobial consumption in Bhutan was 13.27 DIDs in 2017, 14.39 DIDs in 2018, and 16.29 DIDs in 2019.
  • The penicillin group of beta-lactams (J01C) was the most frequently used antimicrobial subgroup.
  • Bhutan's consumption was lower than the EU/EEA average and some other regions, but showed a steady increase.

Conclusions:

  • Antimicrobial consumption in Bhutan shows a consistent upward trend over the study period.
  • While currently lower than some international averages, the increasing trend warrants careful monitoring.
  • Interventions to optimize antimicrobial use are recommended to mitigate potential future resistance issues.