Use of systemic anti-infective agents in Iran during 1997-1998

Objective: Conduction of standardized national drug utilization review to investigate the pattern of systemic anti-infective agent use in Iran. Methods: The wholesale data were used. The Anatomical Therapeutic Chemical (ATC) classification and the defined daily dose (DDD) methodology was employed. Data were presented as DDD/1000 inhabitants/day. Results were compared using national drug statistics of Norway, Sweden, and Denmark. Results: The overall sales of systemic anti-infective agents was 43.5 DDD/1000 inhabitants/day. The parenteral form of drug accounted for 4.20% and broad-spectrum systemic antibacterial agents accounted for 86.2%. The three most commonly used agents, accounting for 74.1% of total sales, were amoxicillin, co-trimoxazole, and ampicillin. Seven kinds of anti-infective agents (17% of total available agents) accounted for 90% of antibacterial use, with dominance of broad-spectrum agents. Comparison showed differences in pattern and intensity of use. The sales of systemic anti-infective agents in general, particularly antibacterials and anti-tuberclotics, were greater in Iran than in three European countries. Broad-spectrum antibacterial agents accounted for a larger proportion of total sales in Iran. Conclusion: The high use of systemic antibacterial agents in general, particularly broad-spectrum agents, suggest the possibility of irrational prescribing, higher prescribed daily doses than DDDs, and a drug wastage. This survey, as a first attempt,. provided an overview of anti-infective use in Iran. Thus, it may serve as a basis for further investigative studies and advanced drug policies.