Analysis of antimicrobial consumption in Peruvian public health services during the COVID-19 pandemic: A...

The COVID-19 pandemic placed unprecedented pressure on health systems and was accompanied by substantial changes in antimicrobial consumption (AMC) worldwide. In Peru, evidence describing national AMC during this period remains limited. This study aimed to describe patterns and temporal trends in AMC within Peruvian public health services between 2019 and 2022.

National consumption data reported to the World Health Organization's GLASS-AMU platform were analysed. AMC was expressed as density in defined daily doses per 1000 inhabitants per day (DID) and stratified by Anatomical Therapeutic Chemical (ATC) group, administration route and AWaRe classification. A descriptive analysis was performed focusing on the distribution of consumption between ATC groups and AWaRe classification.

Annual AMC ranged from 7.91 to 12.38 DID during the study period. Consumption declined in 2020 (7.91 DID), followed by a progressive increase and returning to near pre-pandemic levels in 2022. Among orally administered antimicrobials, broad-spectrum penicillins consistently accounted for the largest share of consumption. In contrast, parenteral AMC was predominantly driven by beta-lactamase-sensitive penicillins. Macrolides and third-generation cephalosporin consumption increased during the pandemic period despite the overall reduction in AMC in 2020. Watch class consumption peaked in 2020 before declining through 2022, while Reserve class showed a constant growth.

These findings indicate that the COVID-19 pandemic was associated with substantial shifts in AMC patterns within the Peruvian public health system and underscore the need to strengthen antimicrobial stewardship and consumption surveillance in a pandemic and post-pandemic context.