Assessment of antibacterial sale in northern Tanzania by using the Anatomic Therapeutic Chemical classification and Defined Daily Dose methodology

J. van den Boogaard, H. H. Semvua, M. J. Boeree, R. E. Aarnoutse, G. S. Kibiki. Tanzania Journal of Health Research, Vol 12, No 3 (2010)
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This study aimed at evaluating the sale of antibacterials for systemic use to outpatients in Moshi, the capital of Tanzania’s northern Kilimanjaro Region. Trained pharmacy assistants of all fourteen pharmacies in Moshi that are authorized to sell antibacterials for systemic use, recorded the sales of antibacterials to outpatients by using the Anatomic Therapeutic Chemical (ATC) classification and Defined Daily Dose (DDD) methodology, during a two-months period. The unregulated availability of antibacterials in drug outlets that are not authorized to sell antibacterials, was assessed in fifteen randomly selected outlets. The total sale of antibacterials was 4.99 DDDs per thousand inhabitants per day (DID). The penicillins were sold most frequently (2.18 DID; 44%), followed by the quinolones (0.63 DID; 13%), macrolides, lincosamides and streptogramins (0.61 DID, 12%), and the tetracyclines (0.57 DID, 11%). The sale of amoxicillin, the individual drug sold most frequently, was 1.28 DID. Ciprofloxacin was available in all unauthorized drug outlets. Given their wide availability in unauthorized drug outlets, the sale of antibacterials by authorized pharmacies in Moshi is probably an underestimation of reality. Regulatory measures to control the availability of antibacterials in Tanzania are warranted. Repetition of the study in different seasons and in consecutive years, could reveal highly relevant data on antibacterial consumption trends, which, especially if correlated to data on antibacterial resistance, could help to control communicable diseases.