Trends in ‘Watch’ and ‘Reserve’ Antibiotic Use in Primary Care in Kazakhstan: The Imperative for Enhancing Stewardship Strategies
Akhmetova K. Makalkina L. Pivina L. Lim L. Aukenov N. Boranbayev K. Stukas R. Belikhina T. Aldiyarova N. Turgambayeva A. Semenova Y.
October 2025Multidisciplinary Digital Publishing Institute (MDPI)
Antibiotics
2025#14Issue 10
Background/Objectives: This study aimed to analyze the consumption of systemic antibacterials (WHO ATC J01) in primary care in Kazakhstan from 2017 to 2024 and to estimate the potential contribution of different primary care providers to the use of “Watch” and “Reserve” antibiotics. Methods: The Global Antimicrobial Resistance and Use Surveillance System methodology was applied to calculate defined daily doses per 1000 inhabitants per day (DID) for ATC J01 overall, as well as at ATC levels 3 and 5. Forecast modeling was performed using ARIMA (0,1,0), ARIMA (0,0,0), and Simple models to project trends through 2030. Pearson’s correlation was computed for each category of primary healthcare provider and each chemical agent belonging to the “Watch” and “Reserve” groups. Results: Antibiotic consumption increased by approximately 1.5 times in 2024 after remaining relatively stable from 2017 to 2023. The forecasts suggest that the share of “Access” group antibiotics will continue to decline, reaching 33.71% by 2030, whereas the share of “Watch” group antibiotics is expected to increase proportionally, reaching 65.73% by 2030. The per capita densities of primary care providers correlate with the consumption of certain “Watch” and “Reserve” group antibiotics. Conclusions: This study demonstrates that the primary care sector in Kazakhstan is characterized by a disproportionately high and increasing use of “Watch” antibiotics, a rising trend in “Reserve” antibiotic consumption, and a declining share of “Access” antibiotics. These findings highlight a need to prioritize stewardship interventions that target the reduction in “Watch” and “Reserve” antibiotics, while promoting the use of “Access” antibiotics.
antibiotic consumption , antimicrobial resistance , antimicrobial stewardship , defined daily doses , healthcare providers , Kazakhstan , primary care
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Department of Public Health and Management, Astana Medical University, Astana, 010000, Kazakhstan
Department of Clinical Pharmacology, Astana Medical University, Astana, 010000, Kazakhstan
Department of Emergency Medicine, Semey Medical University, Semey, 071407, Kazakhstan
Graduate School of Public Policy, Nazarbayev University, Astana, 010000, Kazakhstan
Research Administration, South Kazakhstan Medical Academy, Shymkent, 160001, Kazakhstan
School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Faculty of Medicine, Vilnius University, Vilnius, 01513, Lithuania
Department of Scientific Management, National Research Oncology Center, Astana, 020000, Kazakhstan
Department of Public Health and Management
Department of Clinical Pharmacology
Department of Emergency Medicine
Graduate School of Public Policy
Research Administration
School of Medicine
Faculty of Medicine
Department of Scientific Management
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