Antibiotic Utilization Pattern Based on WHO AWaRe Classification: A Retrospective Study Using Hospital Pharmacy Software Data

Abstract

Introduction: AMR is a global public health threat for near future because it will result in decreased efficacy of antibiotics, failure of treatment, prolonged illness, increased healthcare cost, and high mortality rate. Due to the possibility of antibiotic resistance in near future antibiotic were classified in AWaRe classification by WHO which was the part of the 2017 model list of essential medicine. Access category contains the antibiotics having narrow spectrum activity, with less potency of developing resistance, about 60% of the total consumption must be from this group. This group of antibiotics is the first drug of choice for empirical treatment for infections.

Methods: This is a retrospective descriptive cross-sectional study in which antibiotic dispensing records from Baisakh 1 to Chaitra 30; 2082 BS were included. Data were extracted from the hospital pharmacy software database (Midas). All antibiotics dispensed during the study period were included in the analysis further the data were categorized on AWaRe classification and analyzed.

Results: Based on the WHO AWaRe classification, Watch-group antibiotics accounted for the highest proportion of antibiotic utilization, comprising 312,680 units (55.44%) of the total consumption. Access-group antibiotics contributed 241,351 units (42.79%), while Reserve-group antibiotics accounted for 9,989 units (1.77%). Among the individual antibiotics, cefixime was the most frequently utilized antibiotic, accounting for 137,345 units. This was followed by flucloxacillin (54,864 units), amoxicillinclavulanic acid (54,046 units), doxycycline (43,845 units), and amoxicillin (42,030 units).

Conclusion: The proportion of Access antibiotics remained below the WHOrecommended target of 60%, indicating opportunities for improving antibiotic prescribing and utilization practices.