Antibiotics Consumption in the Eastern Region of Libya 2012-2013.

Afia A. Khalifa, Salma A. Bukhatwa, Mustafa M. Elfakhri


Background:   Drug utilization studies conducted in Libya during the period 1991-2013, have pointed out that there is an irrational use of antibiotics as a common practice that costs the health system more than 7.7 million Libyan Dinars / year. The aim of this study is to assess the trend of antimicrobial consumption in the Eastern region of Libya during 2012 – 2013.

 Methods:   Antimicrobial consumption data from the years 2012 and 2013 were obtained mainly from Benghazi office, Medical Supply Organization (MSO; the only official drug-importing body in Libya). This study is concerned with antibiotics imported only to the Eastern region of Libya, population of which representing approximately 35% of total Libyan population. The WHO, Anatomical-Therapeutic-Chemical (ATC) classification and the Defined Daily Dose (DDD) methodology were used to calculate antibiotic consumption. The total antimicrobial consumption data were calculated as DDD/1000 inhabitants/day.

 Results: Total utilization of antibiotics decreased dramatically from 15.47 DDD/1000 inhabitants/day in 2012 to 4.30 DDD/1000 inhabitants/day in 2013 which in turn shows a significant decline compared to 41.72 DDD/1000 inhabitants/day during the period 1991-1993. Consumption of penicillins decreased from 19.902 DDD/1000 inhabitants/day during 1991-1993 to 1.896 DDD/1000 inhabitants/day during 2012-2013 with pattern of amoxicillin/clavulanic acid consumption which equals 3 times ampicillin consumption and is the highest compared to all penicillins. This was accompanied by a prominent increase in consumption of amphenicols and fusidic acid during 2012-2013, noting that fusidic acid consumption was the highest among all antibiotics.

 Conclusion: MSO since 2011 (post 17th February, 2011 revolution) lost its control over importing medicine due to receiving many drugs, as donations from different international sources without acceptable levels of coordination. This has been reflected on drug purchasing policy of MSO during 2013, which failed to regain the previously accepted level of DDD/1000 inhabitants/day for antibiotics consumption. The decreased consumption of penicillins together with increased consumption of amphenicols and fusidic acid complies with the pattern of antibiotic resistance reported previously in Libya. Similar studies should be conducted to evaluate national drug consumption under normal conditions, to be compared with regional and international data.

Full Text:



World Health Organisation. Guidelines for ATC Classification and DDD assignment. WHO Collaborating Centre for Drug Statistics Methodology; 2003.

World Health Organization. The selection of essential drugs: report of a WHO expert committee. Technical Report Series no 615. Geneva; 1977.

State of Libya [Internet]. 2015 [cited 2015 Jan 1]. Available from:

World Health Organisation. Introduction to Drug Utilization Research. Introduction to Drug Utilization Research. Oslo, Norway; 2003. 33 p.

Čižman M. The use and resistance to antibiotics in the community. Int J Antimicrob Agents [Internet]. 2003;21(4):297–307.

Nordic Council on Medicines. Nordic statistics on medicines 1990-1992. Uppsala, Sweden; 1993.

Khan AA, Sferif SI, Bashir AA, Mangoush M, Gokhale SD, EL-Debani A, El-Fallah MS, Bugaigis A. Drug utilization studies in Benghazi. In: First symposium on drug utilization, Benghazi University. Benghazi, Libya; 1985.

El-Fallah MS, Sharif SI, Khan A, Gokhale SD, Bougaigais A, Mangoush M. A drug center for solving the problem of drug misuse. In: The Third Libyan Pharmaceutical Meeting. Tripoli, Libya; 1982.

Sharif SI, El-Fellah MS, Khan A, Gokhale SD, Bougaigais A, Mangoush M, El-Debani A. Utilization of anti-microbial drugs in two polyclinics in Benghazi. In: The Third Libyan pharmaceutical meeting. Tripoli, Libya; 1982.

El-Kadi AO, Bukhatwa SA, Sharif SI. Prescribing patterns in a polyclinic in Benghazi. In: The Eleventh Congress of the Union of Arab pharmacists. Tripoli, Libya; 1991.

Bashir AA, AL-Wirfaly IA, El-Fakhri MM. Drug prescribing in some polyclinics in Benghazi. In: The Third Jamahiriya Medical Science Conference. Tripoli, Libya; 1996.

Abudejaja A, El-Fellah MS, Gokhale SD, Ghasem SM. Use and abuse of drugs in Libyan Arab Jamahiriya. Garyounis Med J. 1979;2:83–6.

Sharif SI, Kusibat S, Jazwi M, Abdulhafiz S, Ahmed A. One-day study of drug distribution in a private pharmacy. In: The Annual Day of Arab pharmacist. Tripoli, Libya; 1985.

El-Deeb SM, El-Zurgani BS, Sherif S. Drug prescription patterns in polyclinics in Zultan. University of Benghazi; 1994.

Bashir AA, Al-Abani RA, Mahjoub AA. Prescribing practices in three polyclinics in Benghazi-Libya. University of Benghazi; 1997.

El-Siwi RO, Abdullah NI, El-Nemr MS, Bashir AA, Bukhatwa SA. Drug prescribing trends in three polyclinics in Benghazi, Libya (2001-2002). University of Benghazi; 2002.

El-Sheikhi A, Khamis M, Mohamed NA, Bukhatwa SA. Drug-prescribing trends in three polyclinics in Benghazi, Libya 2009. University of Benghazi; 2010.

Ibrahim A, Agelah E, Alzwawi M, Bukhatwa S. Drug prescribing trends in three polyclinics in Benghazi-Libya (2010-2012). University of Benghazi; 2012.

Saad S, Bukhatwa S. Evaluation of rational use of antibiotics in Benghazi-Libya. University of Benghazi; 2013.

Lee D, Bergman U. Studies of drug utilization. In: BL S, editor. pharmacoepidemiology. 2nd ed. Chichester: John Wiley & Sons; 1994. p. 379–89.

Ghenghesh KS, Rahouma A, Tawil K, Zorgani A, Franka E. Antimicrobial resistance in Libya: 1970-2011. Libyan J Med. 2013;8(1).


  • There are currently no refbacks.