Antibiotic consumption in India: geographical variations and temporal changes between 2011 and 2019

Area of Science:

• Pharmacoeconomics
• Global Health
• Antimicrobial Stewardship

Background:

• Antibiotic consumption is a key driver of antimicrobial resistance.
• Understanding private sector antibiotic use in India is crucial for public health initiatives.
• Previous data on systemic antibiotic consumption in India's private sector is limited.

Purpose of the Study:

• To describe and compare private sector systemic (J01) antibiotic consumption across Indian states from 2011 to 2019.
• To analyze trends in antibiotic use, including Access and Watch categories.
• To identify variations in consumption and appropriateness of use between high-focus (HF) and non-high-focus (nHF) states.

Main Methods:

• Utilized the nationally representative PharmaTrac dataset for antibiotic consumption data (DDD).
• Analyzed consumption rates at national, state, and state-group (HF and nHF) levels.
• Employed median, IQRs, relative change, and compound annual growth rate (CAGR) for descriptive and temporal analyses.

Main Results:

• Overall annual consumption rate decreased by 3.6% from 2011 to 2019.
• The share of Access antibiotics declined, and the Access/Watch ratio decreased from 0.59 to 0.49.
• Significant state-level variations in consumption were observed; HF states had lower rates but showed increased inappropriate use over time.

Conclusions:

• India's private sector antibiotic consumption is lower than global rates, but appropriateness of use has declined in most states.
• States demonstrating improved appropriate antibiotic use can serve as models for best practices.
• Further research into factors driving inappropriate use and improved public sector data are needed for comprehensive monitoring.