Antibiotic Procurement Trends and ABC Analysis: Insights from a Three-Year Retrospective Descriptive Study at Benjamin Mkapa Zonal Referral Hospital

Abstract

Background: The lower middle income countries (LMICs) are experiencing exponential procurement expenditure and consumption of antibiotics yearly in primary to tertiary healthcare facilities. The menace of antimicrobial resistance (AMR) is a significant burden on the world economy, leading to financial losses due to reduced productivity from illness (in humans and animals) and increased treatment costs.
Objective: We analysed antibiotic procurement data at a Tanzanian hospital using an ABC analysis method. This could help fight Antimicrobial Resistance by providing insights into consumption patterns and expenditure.
Methodology: A retrospective descriptive study was employed to analyse quantities of antibiotics procured for three years (from 2020 to 2022). Antibiotic total purchasing costs were analysed using the ABC analysis at Benjamin Mkapa Hospital (BMH).
Results: A steady increase in antibiotic procurement was observed, with expenditures rising by 35.83% in 2021 and 59.35% in 2022 compared to 2020. ABC analysis revealed that Category A antibiotics—primarily ceftriaxone, amoxicillin/clavulanic acid, and flucloxacillin/amoxicillin—comprised 12.20% of all antibiotics purchased in 2020 but accounted for over 68% of the total antibiotic expenditure (TZS 116,197,700.00). In 2021, Category A antibiotics represented 15.2% of purchases and 64% of total expenditure (TZS 148,318,885.80), with ceftriaxone, meropenem, and azithromycin being the most frequently procured. By 2022, Category A antibiotics expanded to 23.26% of stocked items and contributed to more than 78% of the total antibiotic spending (TZS 213,033,376.50), with amoxicillin/clavulanic acid, ceftriaxone, and metronidazole being the leading agents.
Conclusion: A steady increase in antibiotic expenditures has been observed. However, the procurement, expenditure, and consumption of Access antibiotics are below the recommended threshold resulting in increased spending and consumption of Watch and Reserve antibiotics. Decreasing the consumption of Reserve antibiotics may help in avoidance or prevention of antimicrobial resistance.