{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:56:08Z","timestamp":1789448168736,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017\u20132019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic\/pharmacological subgroups (ATC level 3), beta-lactam\/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.<\/jats:p>","DOI":"10.3390\/tropicalmed6020077","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T03:28:36Z","timestamp":1620962916000},"page":"77","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["National Antibiotic Consumption for Human Use in Sierra Leone (2017\u20132019): A Cross-Sectional Study"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-6907","authenticated-orcid":false,"given":"Joseph Sam","family":"Kanu","sequence":"first","affiliation":[{"name":"National Disease Surveillance Programme, Sierra Leone National Public Health Emergency Operations Centre, Ministry of Health and Sanitation, Cockerill, Wilkinson Road, Freetown, Sierra Leone"},{"name":"Department of Community Health, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Khogali","sequence":"additional","affiliation":[{"name":"Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-6270","authenticated-orcid":false,"given":"Katrina","family":"Hann","sequence":"additional","affiliation":[{"name":"Sustainable Health Systems, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Tao","sequence":"additional","affiliation":[{"name":"Unit for Antibiotics and Infection Control, Public Health Agency of Sweden, Folkhalsomyndigheten, SE-171 82 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuwary","family":"Barlatt","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"},{"name":"Department of Pharmaceutics and Clinical Pharmacy &amp; Therapeutics, Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Komeh","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Johnson","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Sesay","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Alex","family":"Vandi","sequence":"additional","affiliation":[{"name":"Directorate of Health Security &amp; Emergencies, Ministry of Health and Sanitation, Sierra Leone National Public Health Emergency Operations Centre, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannock","family":"Tweya","sequence":"additional","affiliation":[{"name":"The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe P.O. Box 149, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collins","family":"Timire","sequence":"additional","affiliation":[{"name":"International Union Against Tuberculosis and Lung Disease, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6057-7344","authenticated-orcid":false,"given":"Onome Thomas","family":"Abiri","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"},{"name":"Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawzi","family":"Thomas","sequence":"additional","affiliation":[{"name":"Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Sankoh-Hughes","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Basic Medical Sciences, Faculty of Pharmaceutical Sciences and Faculty of Nursing, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailah","family":"Molleh","sequence":"additional","affiliation":[{"name":"Sustainable Health Systems, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Maruta","sequence":"additional","affiliation":[{"name":"WHO Country Office, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6113-9741","authenticated-orcid":false,"given":"Anthony D.","family":"Harries","sequence":"additional","affiliation":[{"name":"International Union Against Tuberculosis and Lung Disease, 75006 Paris, France"},{"name":"London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S1473-3099(13)70318-9","article-title":"Antibiotic resistance-the need for global solutions","volume":"13","author":"Laxminarayan","year":"2013","journal-title":"Lancet Infect. 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