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

  1. Ebiowei Samuel F. Orubu
  2. Farrukh Malik
  3. Albert Figueras
  4. Carly Ching
  5. Ahsan M Fuzail
  6. Veronika J. Wirtz
  7. Muhammad H. Zaman

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Abstract

Objectives

Uncertainties 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.

Methods

We 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.

Results

The 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.

Conclusions

Total 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.

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    SciScore for 10.1101/2020.12.05.20244657: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were performed on Microsoft Excel; with validation performed on MATLAB.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    MATLAB
    suggested: (MATLAB, RRID:SCR_001622)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.12.05.20244657v1 on medRxiv