Evaluation of hospital-level antibiotic use in Kyrgyzstan between 2016 and 2019 based on the World Health Organization AWaRe classification

Abstract

Introduction and Aim: One of the main goals of the World Health Organization (WHO) global action plan to combat Antimicrobial Resistance is to study the tendency of antimicrobial consumption for systemic use to improve how antimicrobial medications are prescribed and utilized. The objective of the study was to evaluate antibiotic use based on the WHO Access, Watch, Reserve (AWaRe) classification and analyse antimicrobial consumption using Defined Daily Doses in a multidisciplinary hospital in Bishkek, Kyrgyzstan, between 2016 and 2019. Materials and Methods: A retrospective longitudinal analysis of antimicrobial consumption data from a multidisciplinary hospital in Bishkek, Kyrgyzstan, was completed between 2016 and 2019. Information on the structure and volume of antimicrobial consumption, and the number of bed days, was obtained from the internal database and official annual reports of the multidisciplinary hospital. Results: The consumption of levofloxacin increased by 3.935 Defined Daily Doses per 100 Bed-Days (DDD/100BD) (5.6 times) and that of moxifloxacin by 450 DDD/100BD (10.1 times), compared to that in 2016. Notably, the analysis of data on DDD/100BD consumption based on antimicrobial groups identified the most frequently used medications as stationary data points and identified the top-assigned antimicrobials from different groups, which increased in consumption over time. Conclusion: The rapid growth in the use of antibiotics from the Watch class, particularly in low- and middle-income countries, reflects the challenges associated with the rational use of antibiotics. The AWaRe system is an important indicator of efforts to combat Antimicrobial Resistance and ensure equal access to effective antibiotics worldwide.

Time to Treatment and Risk Factors for Unsuccessful Treatment Outcomes among People Who Started Second-Line Treatment for Rifampicin-Resistant or Multi-Drug-Resistant Tuberculosis in the Kyrgyz Republic, 2021

“…Resistance to fluoroquinolones (FQs) is associated with unsuccessful outcomes among people on RR/MDR-TB treatment [ 6 , 7 ]. Access to timely second-line DST results, especially for FQs, is therefore crucial in contexts such as the Kyrgyz Republic, where resistance to FQs may be much higher than the estimated 18% due to widespread and irrational use of FQs in the country [ 8 , 9 ]. This may inform timely clinical decisions regarding effective regimens.…”