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Trends in the consumption of antibiotics in the Lebanese community between 2004 and 2016

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Abstract

Background Antibiotic resistance has reached an alarming rate globally especially in middle-income countries such as Lebanon. The development of antibiotic resistance is strongly linked to the increased population’s injudicious consumption of antibiotics. Objective This study aims to explore the trends of antibiotics consumption in the Lebanese community, between 2004 and 2016, to inform rational use of antibiotics. Setting The study was performed using the Intercontinental Marketing Statistics (IMS) Health Lebanon database Method This is an observational longitudinal study conducted through a review of the IMS database. The annual antibiotics consumption was determined by the Defined Daily Dose (DDD)/1000 inhabitants/day (DID). The trends of antibiotics consumption were then categorized by antibiotic class and spectrum of activity. Main outcome measure The total consumption of antibiotics in Lebanon and the classes of antibiotics used by the community. Results Total community consumption of antibiotics, measured by DDD/1000 inhabitants/day (DID), significantly increased from 18.71 in 2004 to 31.26 in 2016. Penicillin combinations, quinolones, third-generation cephalosporins, tetracyclines, and carbapenems showed significant uptrends, in contrast to first-generation cephalosporins, sulfonamides and diaminopyrimidines, and beta-lactamase resistant penicillins. Broad-spectrum antibiotics showed a marked increase in their consumption from 11.50 DID in 2004 to 22.51 DID in 2016 whereas intermediate-spectrum antibiotics had only a slight increase in their consumption from 7.18 DID in 2004 to 8.51 DID in 2016, and narrow-spectrum antibiotics had a severe decline in their consumption from 0.006 DID in 2004 to 0.0003 DID in 2016. Conclusion There is an alarming increase in antibiotics consumption in Lebanon, particularly broad-spectrum antibiotics. This should be complemented with evidence on the determinants of antibiotic consumption such as prescriber and patient-related factors and drug promotional activities to minimize antibiotics overuse.

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Data availability

The data used in the study was obtained through Intercontinental Marketing Statistics (IMS Health Lebanon).

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Acknowledgements

We thank IMS Health Lebanon for providing us with the antibiotics consumption database.

Funding

This research did not receive any specific grant from funding agencies.

Author information

Authors and Affiliations

  1. CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon

    Nathalie Lahoud, Mira Hleyhel, Rouba Karen Zeidan, Patrick Maison & Nadine Saleh

  2. Institut National de Santé Publique, Epidémiologie Clinique Et Toxicologie, (INSPECT-LB), Beirut, Lebanon

    Nathalie Lahoud, Rana Rizk, Mira Hleyhel, Rouba Karen Zeidan & Nadine Saleh

  3. Faculty of Public Health, Lebanese University, Fanar, Lebanon

    Nathalie Lahoud, Mira Hleyhel, Maryo Baaklini, Rouba Karen Zeidan & Nadine Saleh

  4. Faculty of Pharmacy, Lebanese University, Hadat, Lebanon

    Nathalie Lahoud & Nadine Saleh

  5. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon

    Nahi Ajaka

  6. Centre Hospitalier Universitaire Notre Dame Des Secours, Jbeil, Lebanon

    Nahi Ajaka

  7. Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon

    Deema Rahme

  8. Université Paris Est, 7379, Créteil, EA, France

    Patrick Maison

  9. CHIC, Centre Hospitalier Intercommunal de Créteil, Créteil, France

    Patrick Maison

Authors
  1. Nathalie Lahoud
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  2. Rana Rizk
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  6. Nahi Ajaka
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  8. Patrick Maison
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  9. Nadine Saleh
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Corresponding author

Correspondence to Deema Rahme.

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There was no conflict of interest to declare in this study.

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Not applicable for this study.

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Not applicable for this study.

Ethics approval

The study did not receive an IRB approval because the Lebanese University ethical committee waived the need for IRB approval for this study since it's an observational trend analysis of antibiotic consumption. The study neither involves contact with human beings nor includes any personal identifiers.

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Lahoud, N., Rizk, R., Hleyhel, M. et al. Trends in the consumption of antibiotics in the Lebanese community between 2004 and 2016. Int J Clin Pharm 43, 1065–1073 (2021). https://doi.org/10.1007/s11096-020-01218-7

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  • DOI: https://doi.org/10.1007/s11096-020-01218-7

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