Consumption of antibiotics in a small Pacific Island nation: Samoa

Abstract

High levels of antibiotic use contribute to development of antibiotic resistance. There is little known about levels of antibiotic use in Samoa, although anecdotally, there are high levels of use, and a strain of methicillin-resistant Staphylococcus aureus may have developed there. The study aimed to gather basic data on levels of antibiotic use in Samoa. All those who import medicines into Samoa were interviewed; invoices, prescription records in hospitals, pharmacies and health centres were reviewed; and prospective observation was carried out in private pharmacies. Analysis of orders made in one year provided an estimate of overall antibiotic consumption of 37.3 Defined Daily Doses (DDDs) per 1000 inhabitant days. Penicillins comprised 63% of DDDs used. Antibiotics were around a third of all prescribed drugs in hospitals and pharmacies, and 44% of those dispensed in health centres. Approximately two-thirds of prescriptions dispensed included an antibiotic. A quarter of antibiotic sales in pharmacies were without a prescription. Samoa has high rates of use of antibiotics and very high reliance on penicillins, compared to other developing countries. Levels of prescribing are high compared with other developing nations. It is feasible to calculate total consumption of medicines in very small developing nations.