Expert review of anti-infective therapy · 2026
National trends in antimicrobial consumption in Nepal, 2016-2023: an ecological analysis.
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Satyal Dipen, Pradhan Bijay Lal, Dhungan Ram Chandra, Satyal Dipika, Kapri Laxmi
Аннотация
OBJECTIVE: To characterize class-specific national antimicrobial consumption patterns in Nepal from 2016 to 2023 and explore monotonic and linear temporal patterns, differences between the 2016-2019 and 2020-2023 periods, and the influence of selected high-consumption years.
METHODS: We conducted a retrospective ecological analysis of five antimicrobial classes using annual national consumption expressed as Defined Daily Doses per 1,000 inhabitants per day (DID). Descriptive statistics summarized consumption; Mann-Kendall tests and linear regression explored temporal patterns; an exploratory period comparison assessed 2016-2019 versus 2020-2023; and sensitivity analyses assessed the influence of selected years.
RESULTS: Antibacterial agents had the highest mean consumption at 48.6 defined daily doses per 1,000 inhabitants per day (DID). Considerable year-to-year variability was observed across antimicrobial classes, with limited evidence of sustained temporal trends over the short observation period. Anti-tuberculosis drug consumption showed evidence of an upward monotonic pattern in the Mann-Kendall analysis. However, this finding was not supported by a statistically clear linear trend and was sensitive to exclusion of the 2023 value. Exploratory comparisons of the 2016-2019 and 2020-2023 period showed imprecisely estimated differences in antibacterial and antifungal consumption.
CONCLUSION: National antimicrobial consumption in Nepal exhibited substantial class-specific and annual variation over 2016-2023. The short observation period constrains inference about sustained long-term trends. In particular, the apparent increase in anti-tuberculosis drug consumption warrants cautious interpretation given its sensitivity to 2023, rather than providing definitive evidence of a persistent increase.
METHODS: We conducted a retrospective ecological analysis of five antimicrobial classes using annual national consumption expressed as Defined Daily Doses per 1,000 inhabitants per day (DID). Descriptive statistics summarized consumption; Mann-Kendall tests and linear regression explored temporal patterns; an exploratory period comparison assessed 2016-2019 versus 2020-2023; and sensitivity analyses assessed the influence of selected years.
RESULTS: Antibacterial agents had the highest mean consumption at 48.6 defined daily doses per 1,000 inhabitants per day (DID). Considerable year-to-year variability was observed across antimicrobial classes, with limited evidence of sustained temporal trends over the short observation period. Anti-tuberculosis drug consumption showed evidence of an upward monotonic pattern in the Mann-Kendall analysis. However, this finding was not supported by a statistically clear linear trend and was sensitive to exclusion of the 2023 value. Exploratory comparisons of the 2016-2019 and 2020-2023 period showed imprecisely estimated differences in antibacterial and antifungal consumption.
CONCLUSION: National antimicrobial consumption in Nepal exhibited substantial class-specific and annual variation over 2016-2023. The short observation period constrains inference about sustained long-term trends. In particular, the apparent increase in anti-tuberculosis drug consumption warrants cautious interpretation given its sensitivity to 2023, rather than providing definitive evidence of a persistent increase.