AUTHOR=Frank Edgard Zongo R. , Traoré Kadidjia Bakari , Ngabéré Colette , Yoyammel Martine , Kadai Abatcha Oumar , Efobi John Eyong , Hota Mathieu , Lamireou Didi , Mahamat Badawi Haroun , Alio Hamit Mahamat , Tamuzi Jacques L. , Katoto Patrick D. M. C. , Wiysonge Charles S. , Anya Blanche-Philomene Melanga 

TITLE=National antibiotic consumption for human use in Chad (2017–2021): a descriptive cross-sectional study

JOURNAL=Frontiers in Antibiotics

VOLUME=Volume 4 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/antibiotics/articles/10.3389/frabi.2025.1612557

DOI=10.3389/frabi.2025.1612557

ISSN=2813-2467

ABSTRACT=BackgroundAntibiotic resistance (ABR) to commonly used antibiotics is significant in sub-Saharan Africa (SSA). In SSA, Chad has one of the highest antimicrobial resistance (AMR) rates. The link between ABR and antibiotic consumption (ABC) is well-established. However, no ABC-related studies have been conducted in Chad recently. The purpose of this study is to examine the trajectory of ABC in Chad from 2017 to 2021, using the World Health Organization’s (WHO) Access, Watch, and Reserve (AWaRe) antibiotic classification.MethodsA descriptive retrospective study was conducted in N’Djamena, using antibiotic import and distribution data collected from the General Directorate of Pharmacy and four wholesale distributors of medicines. The defined daily doses (DDDs) and the mean relative change (MRC) were used to compute the results. Results were presented in terms of tables and graphs. The results were compared to the WHO’s guidelines for ABC use via the AWaRe categorization.ResultsBetween 2017 and 2021, an average ABC of 2.5 doses per inhabitant per year was observed, peaking in 2020 at 5.3 doses per inhabitant. In terms of DDD, the ten most commonly consumed antibiotics during the time, in descending order, were amoxicillin, ampicillin, sulfamethoxazole/trimethoprim, doxycycline, ciprofloxacin, phenoxymethyl-penicillin, erythromycin, ceftriaxone, azithromycin, and gentamicin. However, the MRC analysis detected an increase in benzathine benzyl penicillin, benzylpenicillin, ampicillin, amoxicillin+clavulanic acid, flucloxacillin, ceftriaxone, cefixime, cefpodoxime and cefalexin, cotrimoxazole, ciprofloxacin, levofloxacin, norfloxacin, ofloxacin, and azithromycin. Controversially, amoxicillin, cefotaxime, doxycycline, erythromycin, and moxifloxacin had a lower MRC from 2017 to 2021. Although 90% of the ABC are from the “Access” group, the “Watch” group has increased over time.ConclusionsOur findings indicated a significant ABC in the Chadian population from 2017 to 2021, which may elucidate the country’s elevated ABR. On average, 90% of ABC were categorized in the “Access” group, although utilization of the Watch group increased over time. This requires the prompt implementation of the monitoring system for ABC at all tiers in Chad.