Five-year analysis of antibiotic consumption at university teaching hospitals in Tunisia

A national antimicrobial consumption reporting system has been established in Tunisia, however, regional, hospital and departmental data on consumption remain limited.

To assess annual antibiotic consumption trends in Tunisia's university teaching hospitals from 2018 to 2022.

We analysed data on antibiotic consumption for 2018 to 2022 by patients aged ≥18 years admitted into 5 university teaching hospitals in Tunisia, based on the WHO defined daily doses per 1000 inhabitants per day and the access, watch and reserve classification. We assessed the differences between year, region, specialty and antibiotic classifications using the Friedman test. P ≤ 0.05 was considered statistically significant.

There was no significant difference in antibiotic consumption between the 5 hospitals over the 5-year period (P = 0.455). However, there were consistent significant differences between hospitals in the different regions and between antibiotic categories. There were significant differences in antibiotic consumption between the different hospital departments. The highest consumption was observed in the intensive care units (increasing from 154.2 defined daily doses per 1000 inhabitants per day in 2018 to 174.9 in 2022), which also had the highest increase in the consumption of reserve antibiotics (12.6% in 2018 to 16.7% in 2022).

The relatively stable antibiotic consumption observed in our study does not imply appropriate use. There is a need for robust antibiotic use surveillance systems in Tunisian hospitals, especially in intensive care units, alongside targeted interventions to effectively address antimicrobial resistance.