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Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar

(1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patter...

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Autores principales: Pwint, Khin Hnin, Min, Kyaw Soe, Tao, Wenjing, Shewade, Hemant Deepak, Wai, Khin Thet, Kyi, Hnin Aye, Shakya, Sushma, Thapa, Badri, Zachariah, Rony, Htun, Zaw Than
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167548/
https://www.ncbi.nlm.nih.gov/pubmed/33924003
http://dx.doi.org/10.3390/tropicalmed6020057
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author Pwint, Khin Hnin
Min, Kyaw Soe
Tao, Wenjing
Shewade, Hemant Deepak
Wai, Khin Thet
Kyi, Hnin Aye
Shakya, Sushma
Thapa, Badri
Zachariah, Rony
Htun, Zaw Than
author_facet Pwint, Khin Hnin
Min, Kyaw Soe
Tao, Wenjing
Shewade, Hemant Deepak
Wai, Khin Thet
Kyi, Hnin Aye
Shakya, Sushma
Thapa, Badri
Zachariah, Rony
Htun, Zaw Than
author_sort Pwint, Khin Hnin
collection PubMed
description (1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patterns in total defined daily doses (DDDs). (2) Methods: We followed World Health Organization (WHO) methodology for surveillance of antimicrobial consumption based on hospital antibiotic procurement records (as a proxy). (3) Results: In 32% of all public hospitals where data were retrieved, total antibiotic consumption reduced by 19% between 2014 (7,122,852 DDD) and 2017 (5,794,904 DDD). Consumption per 1000 inhabitants per day (<200 bed hospitals) also reduced from 0.6 to 0.3. Over 60% of procurement was for beta-lactam antibiotics and quinolones; quinolones decreased over time. Consumption of first-line antibiotics increased (42% in 2014 to 54% in 2017), whereas broad-spectrum antibiotics decreased (46% in 2014 to 38% in 2017). Linezolid was the only last-resort antibiotic procured. There was a progressive reduction in per capita government current health expenditure from approximately 9.2 US$ in 2014 to 8.3 US$ in 2017. (4) Conclusions: Antibiotic consumption decreased over time in public hospitals. This first study provides a baseline for developing an antibiotic consumption surveillance system in Myanmar.
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spelling pubmed-81675482021-06-02 Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar Pwint, Khin Hnin Min, Kyaw Soe Tao, Wenjing Shewade, Hemant Deepak Wai, Khin Thet Kyi, Hnin Aye Shakya, Sushma Thapa, Badri Zachariah, Rony Htun, Zaw Than Trop Med Infect Dis Article (1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patterns in total defined daily doses (DDDs). (2) Methods: We followed World Health Organization (WHO) methodology for surveillance of antimicrobial consumption based on hospital antibiotic procurement records (as a proxy). (3) Results: In 32% of all public hospitals where data were retrieved, total antibiotic consumption reduced by 19% between 2014 (7,122,852 DDD) and 2017 (5,794,904 DDD). Consumption per 1000 inhabitants per day (<200 bed hospitals) also reduced from 0.6 to 0.3. Over 60% of procurement was for beta-lactam antibiotics and quinolones; quinolones decreased over time. Consumption of first-line antibiotics increased (42% in 2014 to 54% in 2017), whereas broad-spectrum antibiotics decreased (46% in 2014 to 38% in 2017). Linezolid was the only last-resort antibiotic procured. There was a progressive reduction in per capita government current health expenditure from approximately 9.2 US$ in 2014 to 8.3 US$ in 2017. (4) Conclusions: Antibiotic consumption decreased over time in public hospitals. This first study provides a baseline for developing an antibiotic consumption surveillance system in Myanmar. MDPI 2021-04-20 /pmc/articles/PMC8167548/ /pubmed/33924003 http://dx.doi.org/10.3390/tropicalmed6020057 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pwint, Khin Hnin
Min, Kyaw Soe
Tao, Wenjing
Shewade, Hemant Deepak
Wai, Khin Thet
Kyi, Hnin Aye
Shakya, Sushma
Thapa, Badri
Zachariah, Rony
Htun, Zaw Than
Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title_full Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title_fullStr Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title_full_unstemmed Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title_short Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar
title_sort decreasing trends in antibiotic consumption in public hospitals from 2014 to 2017 following the decentralization of drug procurement in myanmar
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167548/
https://www.ncbi.nlm.nih.gov/pubmed/33924003
http://dx.doi.org/10.3390/tropicalmed6020057
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