Antibiotic Utilisation Patterns in Tanzania: A Retrospective Longitudinal Study Comparing Pre- and Post-COVID-19 Pandemic Using Tanzania Medicines and Medical Devices Authority Data

Synopsis Background Antimicrobial resistance (AMR) is a growing public health concern globally, and misuse of antibiotics is a major contributor. Objective This study investigated antibiotic utilisation patterns before and after the COVID-19 pandemic in Tanzania using data from the Tanzania Medicines and Medical Devices Authority (TMDA). Methods This retrospective longitudinal study analysed secondary data. The study compared antibiotics consumption in defined daily doses (DDD) per 1000 inhabitants per day (DID) in two distinct eras: 2018-2019 as the pre-COVID-19 era and 2020-2021 as the post-COVID-19 era. Data was reorganised using Microsoft Power BI, and statistical analysis was conducted using SPSS software. Results The study analysed 10,614 records and found an overall increase in antibiotics consumption from 2018 to 2021. When we divided the consumption of antibiotics into a pre- and post-COVID time period, with the pre-COVID period being 2018 and 2019 and the post-COVID period being 2020 and 2021, we found that the consumption was 61.24 DID in the post-COVID era and 50.32 DID in the pre-COVID era. Levofloxacin had the highest percentage increase in use, with a 700% increase in DID after the pandemic. Azithromycin had a 163.79% increase, while cefotaxime had a 600% increase. In contrast, some antibiotics exhibited a decrease in usage after the pandemic, such as nalidixic acid, which had a 100% decrease, and cefpodoxime, 66.67% decrease. Conclusion The increase in antibiotic consumption during the COVID-19 pandemic highlights the importance of implementing effective antimicrobial stewardship strategies to prevent AMR, especially during pandemics.