Sales of antimicrobials for veterinary use, Bangladesh, 2023.

OBJECTIVE: To estimate the volume and patterns of antimicrobial sale for food-producing animals in Bangladesh and to provide evidence to support national policy decisions. METHODS: We used the World Organisation for Animal Health tool (animal antimicrobial use calculation module) for data collection and calculation of quantities of antimicrobials used in animals. We collected data on the overall amount of antimicrobials sold for use in food-producing animals, disaggregated by antimicrobial class, active molecule and route of administration. FINDINGS: In 2023, 475 750 kg of antimicrobials were sold for use in animals across 301 products and 38 molecules. Oral administration accounted for 95.91% (456 301/475 750) of total antimicrobials sold. Tetracyclines were the most sold antimicrobial class, accounting for 32.22% (153 274/475 750) of antimicrobials sold for use in food-producing animals. The second most-sold class was aminoglycosides at 19.77% (94 044/475 750) of total sales. As regards to active molecules, chlortetracycline, neomycin, ceftriaxone, oxytetracycline, metronidazole, sulfamethoxazole, ciprofloxacin and enrofloxacin accounted for 79.34% (377 438/475 749) of the total national antimicrobial sale. Just over one fifth of the antimicrobials sold belong to classes considered to be highest priority critically important antimicrobials for humans (according to the World Health Organization's list). These classes were third- and fourth-generation cephalosporins, fluoroquinolones, other quinolones and polymyxins. CONCLUSION: Our findings highlight antimicrobial overuse and misuse in food-producing animals in Bangladesh and the need for policy interventions to combat antimicrobial resistance. Our report provides baseline data to support Bangladesh's National action plan on antimicrobial resistance and enable evidence-based policy development and strengthening of antimicrobial stewardship in the veterinary sector.