Antibacterial Medicine Consumption in Private and State Sector Outpatient Settings in Colombo District, Sri Lanka

Introduction: Objective of this study was to determine the quantities and patterns of antibacterial medicine (ABM) consumption in the public and private hospital outpatient settings in Colombo District.

 

Methods: A descriptive cross-sectional study was conducted in outpatient settings of selected State and private hospital settings between 2012 and 2013. 2009-WHO methodology was adapted to suit the Sri Lankan healthcare system. Oral systemic aggregated ABM (J01) consumption data was collected and categorized using Anatomical Therapeutic Chemical classification system. It was quantified using Defined Daily Doses (DDDs), and DDDs per 1000 outpatients per day (DID). Results were interpreted using descriptive statistics.

 

Results: ABM consumption was 4.21DID and 3.46DID from private and State hospitals respectively. Most common ABM subgroup was penicillin in both private (1.34 DIDs) and State hospitals (2.67 DIDs) followed by macrolides (private hospital = 0.79 DIDs, State hospital = 0.36 DIDs). Five ABMs contributed to 90% drug utilization in State hospitals compared to 12 in private hospitals. Ratio of the consumption of broad spectrum penicillins: narrow spectrum penicillins, cephalosporins and macrolides were 30:1 and 04:1 in private and State hospitals respectively. Amoxicillin (60.3 %) was the predominantly consumed ABM in State hospitals compared to co-amoxiclav (22.9%) in private hospitals.

 

Conclusion: Consumption of conventional ABM predominates in State outpatient settings whereas newer broader spectrum ABM in private hospital outpatient settings. The findings highlight the need for antimicrobial stewardship, especially in private hospital outpatient settings. Furthermore, the Ministry of Health, Nutrition and Indigenous Medicine of Sri Lanka should intervene to maintain complete ABM dispensed data of institutionalized ABM consumption surveillance in Sri Lanka.