Seven-year analysis of national antibiotic consumption in Tunisia

Monitoring national antibiotic consumption is essential to strengthen antimicrobial stewardship and efforts to combat antimicrobial resistance.

To assess annual antibiotic consumption in Tunisia from 2016 to 2023.

Using SPSS version 27, Spearman correlation, the WHO defined daily dose per 1000 inhabitants per day and the WHO access, watch and reserve classification, we analysed national antibiotic consumption data in Tunisia for 2016 to 2023.

Overall antibiotic consumption increased from 31.6 defined daily dose per 1000 inhabitants per day in 2016 to 32.4 in 2023, with lower values for 2019-2022 (P = 0.096). Private sector consumption consistently exceeded public sector levels and access group antibiotics were the most consumed (78% in 2016, 65% in 2021 and 75% in 2023). Beta-lactam penicillins was most consumed (exceeding 60% in most years), followed by macrolides, lincosamides and streptogramins (≈10% in most years), while oral antibiotics represented 98% of total consumption.

The predominance of generics indicates the need for vigilant antimicrobial stewardship to prevent costdriven overuse and mitigate resistance. There is a need to strengthen national antibiotic use surveillance, including in private sector facilities, and promote a more rational use of antibiotics.