What does this research mean for the field?

Antibacterial consumption in Kenya increased from 2020 to 2024, with the proportion of Access category antibiotics remaining below the WHO 60% target alongside a concerning rise in Watch category antibiotics such as ceftriaxone and azithromycin. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To estimate national and hospital-level antibacterial consumption patterns in Kenya and assess implications for antibiotic resistance.

June 12, 2026Open Access

National and Hospital Level Antimicrobial Consumption Patterns in Kenya

Key Points

To estimate national and hospital-level antibacterial consumption patterns in Kenya and assess implications for antibiotic resistance.
Analyzed national consumption data from January 2023 to December 2024 from import and donation permits.
Retrieved historical antibiotic data from WHO GLASS for the years 2020 and 2021.
Collected hospital-level antibiotic data from ten facilities between January 2024 and April 2025.
National antibiotic consumption increased from 14.3 DID in 2020 to 22.2 DID in 2024.
Consumption of Access category antibiotics was below the WHO target of 60%, ranging from 50.4% to 61.2%.
The rise in Watch antibiotics, particularly ceftriaxone and azithromycin, raised concerns for antimicrobial resistance strategies.

Abstract

Background: Robust antimicrobial consumption monitoring and correlation with antibiotic resistance trends is critical to informing evidence-based antimicrobial stewardship and is recommended by the World Health Organization Global Action Plan on the containment of antimicrobial resistance. We estimated national and hospital-level antibacterial consumption patterns in Kenya. Materials and methods: National consumption data (January 2023–December 2024) was derived from aggregated import and donation permits at the Pharmacy and Poisons Board and standardized using the WHO ATC/DDD Index 2025. Consumption data for 2020 and 2021 that had been previously submitted by Kenya to WHO GLASS was retrieved and incorporated to allow a description of trends. Hospital-level data was collected from ten facilities across the country for the period from January 2024 to April 2025. Quality of use was evaluated using the WHO Access, Watch, and Reserve (AWaRe) categorisation with high-consumption antibiotics identified using the Drug Utilization 75% metric. Results: There was a gradual increase in national antibiotic consumption from 14.3 DID in 2020 to 22.2 DID in 2024. Oral formulations accounted for more than three quarters of antibiotics consumed. Access category antibiotic consumption ranged from 50.4% to 56.9% nationally and was 61.2% at hospital level. The national consumption of Watch antibiotics increased from 38.9% in 2020 to 46.1% in 2023 and declined to 40.7% in 2024. Amoxicillin and amoxicillin/clavulanic acid were the most commonly consumed antibiotics nationally in 2020 (40%), 2021 (27%) and 2024 (33%). Azithromycin was the most commonly consumed antibiotic in 2023 (27%), rising from 10% in 2020. Among parenteral antibiotics, benzylpenicillin was the most commonly consumed in 2020 and 2021, while ceftriaxone was the most commonly consumed agent in 2023 (24%) and 2024 (41%). At hospital level, ceftriaxone accounted for 56.5% of parenteral antibiotic use in county referral hospitals. Conclusions: Kenya’s antibacterial consumption is increasing. Use of Access antibiotics remains below the WHO target of 60%. The increasing use of Watch antibiotics, and in particular ceftriaxone and azithromycin, needs to be addressed to support Kenya’s efforts against antimicrobial resistance.

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