Evaluation of Antibiotic Use in Kazakhstan for the Period 2017-2019 Based on WHO Access, Watch and Reserve Classification (AWaRe 2019).

The purpose of this study is to conduct a comparative analysis of the consumption of antibiotics for systemic use reimbursed by the state in Kazakhstan for 2017-2019 with the Access, Watch, and Reserve classification (AWaRe 2019) of the World Health Organization (WHO). The evaluation of the consumption of antibiotics for systemic use in Kazakhstan for 2017-2019 was carried out using the ATC/DDD methodology in accordance with the WHO AWaRe classification. The study used data on all antibiotics that were centrally purchased by a single purchaser during the study period. To understand how often Access group antibiotics are taken in Kazakhstan, the top-10 most consumed antibiotics were additionally studied. The results of a comparative analysis of the antibiotics for systemic use consumption for 2017-2019 by the Access, Watch, and Reserve groups showed a negative trend of a decrease in the consumption of Access group drugs from 1.17 defined daily dose (DDDs) per 1000 inhabitants per day (DID) (39%) in 2017 to 0.59 DID (30%) in 2019. There is an increase in consumption of Watch group antibiotics from 1.84 DID (61%) in 2017 to 1.37 DID (68%) in 2019, as well as an increase in consumption of Reserve antibiotics from 0.001 DID (0.03%) to 0.4 DID (2.11%). In recent years in Kazakhstan, there has been a decrease in the consumption of Access group antibiotics. In addition, the Watch group antibiotics are widely consumed with a certain upward trend. In 2019, one Reserve antibiotic was included in the top-10 most commonly consumed antibiotics. There is a predominant consumption of parenteral forms of antibiotics for systemic use in the country.

The Evaluation of Antibiotic Consumption at the Inpatient Level in Kazakhstan from 2011 to 2018.

Antimicrobial agents have a rather special position due to their importance as essential medicines for the treatment of infectious diseases. Evidence-based prescriptions are needed to optimize the use of antimicrobials in humans, as well as to decrease antimicrobial resistance. The aim of this study was to assess the inpatient consumption of antimicrobial drugs for systemic use in the period 2011-2018 in Kazakhstan. This article presents the results of an evaluation of the inpatient use of antibacterial drugs for systemic use (group J01) for the period 2011-2018 using the anatomical therapeutic chemical (ATC) classification)/defined daily dose (DDD) methodology recommended by the World Health Organization. Inpatient antimicrobial utilization is expressed as DDDs/1000 inhabitants/day (DID). The results of the assessment for inpatient antibiotic use (over an eight-year period) showed a decrease in the total consumption of antibiotics for systemic action in Kazakhstan (2011: 12.72 DID; 2018: 2.74 DID). Among oral formulations, levofloxacin was consumed the most, and cefazolin was consumed the most among the parenteral formulations of antimicrobials. The three drugs consumed the most included cefazolin (first-generation cephalosporin), ceftriaxone (third-generation cephalosporin), and cefuroxime (second-generation cephalosporin). The total consumption of antibacterials for systemic action in Kazakhstan decreased during the analyzed period, but there was an irrational use of certain groups of drugs.