Comparative assessment of antibacterial drugs used at the hospital level before and during COVID-19, according to the WHO AWaRe classification

Aigerim Balapasheva^1*Gaziza Smagulova¹Aigul Mussina¹Daniyar Dilmagambetov¹Kalzhan Yermekbayeva¹Mirsaid Kelimberdiev¹Mariya Kulnazarova¹Lazzat Balymbetova¹Liliya Ziganshina^2,3,4

• ¹West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan
• ²Rossijskaa medicinskaa akademia nepreryvnogo professional'nogo obrazovania, Moscow, Russia
• ³Rossijskij universitet druzby narodov, Moscow, Russia
• ⁴Kazan State Medical University, Kazan, Russia

This study provides a detailed analysis of antibiotic consumption in an outpatient hospital in Aktobe, Kazakhstan, from 2019 to 2021, utilizing the World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) classification. The primary objective is to evaluate the use of systemic antibacterials and to advocate for the AWaRe classification as a management tool for effective antibiotic use and performance indicator establishment. The findings reveal concerning trends in irrational antibiotic consumption, with the proportion of "Access" antibiotics fluctuating from 24% in 2019 to 26.9% in 2021, which falls short of WHO recommendations. Notably, there was a significant reliance on "Watch" antibiotics, particularly during the COVID-19 pandemic, with cephalosporins, fluoroquinolones, and carbapenems being the most frequently prescribed. These results underscore the critical need for implementing the AWaRe classification database in Kazakhstan to optimize antibiotic use, establish performance targets, and create a dedicated group for monitoring and regulating antibiotic prescriptions. This study enhances the global understanding of antibiotic consumption trends and the challenges faced in adhering to international guidelines, especially in light of the pandemic and the escalating threat of antibiotic resistance.