孟加拉国抗生素市场评估：世界卫生组织 AWaRe 分类和剂型供应对抗菌药耐药性的影响。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2024-11-06 DOI:10.1016/j.jiph.2024.102587

Joya Rani , Sudipta Saha , Fahmi Ferdous , Md. Ajijur Rahman

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引用次数: 0

摘要

背景：由于普遍存在自行用药和使用不当的情况，抗生素无需处方即可获得，这导致抗生素耐药性的威胁不断上升。在这项研究中，我们旨在根据世界卫生组织的 AWaRe（获取、观察、储备）分类系统对孟加拉国的抗生素市场进行评估，以更好地了解不受管制地获取抗生素会如何影响该国的自我药疗行为和抗生素耐药性的出现：从孟加拉国药品索引智能手机应用程序、孟加拉国国家处方集（BDNF）和药品管理总局（DGDA）网站收集了有关 AWaRe 类抗生素、其强度和剂型的数据。销售数据通过 IQVIA 数据进行分析，以确定抗生素的市场价值和复合年增长率 (CAGR)。分析的重点是根据世界卫生组织的 AWaRe 分类对抗生素进行分类，并检查其各种剂型和强度（包括适合儿童的制剂）的可用性：孟加拉国现有的 81 种抗生素中，54.32% 属于观察类，30.86% 属于使用类，8.64% 属于储备类，6.17% 属于未分类。从 ATC 分类来看，大多数（91.35%）属于 J01 类。大多数抗生素有多种剂型和强度，其中最常见的是片剂（54.87%）、注射剂（48.78%）和胶囊剂（30.48%）。此外，35.8%的抗生素有适合儿童的剂型。口服制剂非常普遍，88.0%的Access、75.0%的Watch和28.57%的Reserve类抗生素都有口服制剂。共发现 56 种抗生素复方制剂，包括 6 种世界卫生组织推荐的和 2 种世界卫生组织不推荐的固定剂量复方制剂。从销售额和复合年增长率来看，观察类抗生素在市场上占据主导地位：观察类抗生素的广泛供应，尤其是口服制剂和儿童适用制剂的广泛供应，表明有必要采取更严格的监管和公共卫生干预措施，以遏制抗生素的自我药疗、不当营销和使用，从而降低耐药性风险。

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Assessment of the Bangladeshi antibiotic market: Implications of the WHO AWaRe classification and dosage form availability on antimicrobial resistance

Background

Availability of antibiotics without prescription contributes to the rising threat of antibiotic resistance due to widespread self-medication and improper use. In this study, we aimed to assess the antibiotic market in Bangladesh according to the WHO AWaRe (Access, Watch, Reserve) classification system to better understand how the unregulated access of antibiotics may influence self-medication practices and the emergence of antibiotic resistance in the country.

Methods

Data on AWaRe class antibiotics, their strengths, and dosage forms were collected from Bangladeshi drug indexing smartphone applications, the Bangladesh National Formulary (BDNF), and the Directorate General of Drug Administration (DGDA) website. Sales data were analyzed using IQVIA data to determine the market value and compound annual growth rates (CAGR) of antibiotics. The analysis focused on categorizing antibiotics according to the WHO AWaRe classification and examining their availability in various dosage forms and strengths including child-appropriate formulations.

Results

Of the 81 antibiotics available in Bangladesh, 54.32 % belong to the Watch class, 30.86 % to Access, 8.64 % to Reserve, and 6.17 % were unclassified. In terms of ATC classifcation, the majority (91.35 %) belonged to the J01 class. Most antibiotics were available in multiple dosage forms and strengths, with tablets (54.87 %), injections (48.78 %), and capsules (30.48 %) being the most common. Additionally, 35.8 % of antibiotics were available as child-appropriate formulations. Oral formulations were prevalent, with 88.0 % of Access, 75.0 % of Watch, and 28.57 % of Reserve class antibiotics were available in oral dosage forms. A total of 56 antibiotic combinations were identified, including six WHO-recommended and two WHO-not-recommneded fixed-dose combinations. Watch class antibiotics dominated the market in terms of sales value and CAGR.

Conclusion

The widespread availability of Watch class antibiotics, particularly in oral and child-appropriate formulations suggest a need for stricter regulation and public health interventions to curb self-medication, inappropriate marketing and use of antibiotics to mitigate the risks of resistance.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.