20 November 2018

East Africa: Tanzania, Burundi Lead in Consumption of Antibiotics in East Africa

Tanzania and Burundi are among the top four countries in Africa in consumption of antibiotics, new data published by the World Health Organisation shows.

Tanzania and Burundi consume 27.3 and 4.4 defined daily doses (DDD) per 1,000 inhabitants per day respectively. Burkina Faso is second at 13.8 DDD per 1000 inhabitants per day while Côte d'Ivoire, at 10.7 DDD, is third.

In Burundi, penicillins (J01C) were by far the most frequently consumed antibiotic subgroup at 78 per cent.

In all countries but Burundi, oral formulations accounted for the vast majority of antibiotics consumed at between 96 and 98 per cent.

In Burundi, 24 per cent of antibiotics consumed were oral and 76 per cent were injected.

"The high proportion of parenteral formulations is probably because of the overrepresentation of hospital consumption," reads the report.

In Tanzania, Burkina Faso and Cote d'Ivoire, amoxicillin, sulfamethoxazole/trimethoprim and ciprofloxacin contributed to 75 per cent of the total oral antibiotic consumption.

For antibiotics given by injection ceftriaxone was the most commonly consumed in Burkina Faso and Côte d'Ivoire, accounting for an average proportional consumption of 41 per cent, while in Tanzania and Burundi, gentamicin and benzylpenicillin, respectively, were the most consumed antibiotics.

The report finds wide discrepancies in consumption rates between countries, ranging from approximately four defined daily doses per 1,000 inhabitants per day to more than 64 DDD.

The large difference in antibiotic use worldwide indicates that some countries are probably overusing antibiotics while other countries may not have sufficient access to these life saving medicines.

"Overuse and misuse of antibiotics are the leading causes of antimicrobial resistance. Without effective antibiotics and other antimicrobials, we will lose our ability to treat common infections like pneumonia," said Suzanne Hill, director of the Department of Essential Medicines and Health Products at WHO.

"Findings from this report confirm the need to take urgent action, such as enforcing prescription-only policies, to reduce unnecessary use of antibiotics," she added.

Sales data

African countries' total consumption is based on sales data from wholesalers for 2015, save for Tanzania, which provided data from 2016 based on imports.

In Burundi was retrieved from the central medical store, which mainly provide medicines to the public sector, including many hospitals. Therefore, the results from Burundi represent mostly consumption in the hospital sector.

For the first time, WHO has collated data on antibiotic consumption for human health care from 65 countries and areas.

Overall, the report finds that amoxicillin and amoxicillin/clavulanic acid are the most frequently used antibiotics worldwide.

These medicines are recommended by WHO as first or second-line treatments for common infections and belong to the "Access" category of the WHO Model List of Essential Medicines. In 49 countries, the Access category represents more than 50 per cent of antibiotic consumption.

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