Antibacterial consumption in the context of COVID-19 in Pakistan: an analysis of national pharmaceutical sales data for 2019-20

ObjectivesUncertainties in the pharmaceutical management of COVID-19 have led to reports of increased indiscriminate uses of antibiotics. The aim of this study was to investigate this at a national level in Pakistan. MethodsWe used IQVIA pharmaceutical sales volume data to analyze antibiotic consumption for January-April 2020 in Pakistan. The consumption of 77 antibiotics for systemic use in 2020 was calculated, and compared against the same period in 2019 to track changes in total consumption and consumption pattern by six assigned therapeutic groups: tetracyclines, quinolones, beta-lactam penicillins, other-beta-lactams, macrolides and "others" - comprising the remaining groups. ResultsThe total consumption for January-April 2020 was 17.76 Defined Daily Doses per 1000 population per day (a 18.8% decrease from 2019). Quinolones, beta-lactam penicillins, other-beta-lactams, and macrolides constituted 80% of total consumption. There were increases between February-April 2020 of macrolides and "others". In March 2020, 112768 more people consumed a macrolide per day compared to March 2019; mostly azithromycin. ConclusionsTotal consumption decreased in the first four months of 2020 compared to 2019, possibly arising from a combination of several pre-existing and concurrent economic conditions as well as the lockdown situation. However, the results suggest an increase in the consumption of the macrolide class of antibiotics during the early phase of COVID-19 in Pakistan.