Journal of Pharmaceutical Policy and Practice · Available online 21 May 2026 · In press · DOI 10.1080/20523211.2026.2668477
Audrey Huili Lim, Norazida Ab Rahman, Siti Nur Su'Aidah Nasarudin, Abdul Haniff Mohamad Yahaya, Mardhiyah Kamal, Marziaty Shazreena Mohd Shah, Nurul Hidayah Awang, Benedict Lim Heng Sim, Suresh Kumar Chidambaram, Sheamini Sivasampu, Peter Seah Keng Tok
Background Evaluating national antibiotic use is crucial for understanding the drivers of antimicrobial consumption and resistance, to develop targeted strategies that promote rational antibiotic use amid limited existing evidence. The aim of this study was to examine the trends and patterns in national antibiotic utilisation and associated expenditure in Malaysia.Methods National pharmaceutical sales data from IQVIA was used to obtain data on antibiotics from 2019 to 2023. Antibiotic utilisation rate was presented as defined daily dose (DDD) per 1000 inhabitants per day and expenditure as total cost in Malaysian Ringgit (MYR) per 1000 inhabitants. The proportion of antibiotics was further classified into Access, Watch, Reserve (AWaRe) categories. Compound Annual Growth Rate (CAGR) was used to calculate the changes in utilisation and expenditure rate over time.Results Overall, two-thirds of the total antibiotic utilisation was contributed by primary care and the utilisation in the private sector was higher than that in the public sector for both primary care and hospitals. Antibiotic utilisation rate showed a non-significant change in trend between 2019 and 2023 (CAGR = −0.25%; p = 0.869). Annual antibiotic expenditure was MYR3525.90 per 1000 inhabitants in 2019 and MYR3822.37 per 1000 inhabitants in 2023, but also exhibited a non-significant trend change (CAGR = 3.1%; p = 0.869). The Access category antibiotics accounted for 56.0% of total antibiotic usage, with varying proportions observed between hospitals and clinics and public-private setting. Access-to-Watch Index was 3.18 in public and 1.14 in the private sector. The highest proportion of Watch antibiotics was in private hospitals and the Access antibiotics were highest in public clinics.Conclusion While the antibiotic utilisation rate showed a fairly stable trend, the proportion of Access antibiotics falls short of the 60% target set by the WHO. Study findings contribute to informing efforts to strengthen and target stewardship efforts in Malaysia.
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Lim, A., Rahman, N., Nasarudin, S., et al. (2026). Landscape of national antibiotic utilisation in Malaysia: an analysis of national pharmaceutical sales data from 2019 to 2023. Journal of Pharmaceutical Policy and Practice. https://doi.org/10.1080/20523211.2026.2668477