# Antimicrobial sales profile in Brazil from 2014 to 2021: analysis of records from the National System of Controlled Products Management

## TL;DR

This study analyzed antimicrobial sales in Brazil from 2014 to 2021, revealing regional, gender, and age-based trends and the impact of the pandemic.

## Contribution

The study provides a detailed analysis of antimicrobial sales patterns in Brazil using national regulatory data.

## Key findings

- Antimicrobial sales increased until 2019, dropped during the 2020 pandemic, and rose again in 2021.
- The Southeast and Northeast regions had the highest sales, with women aged 30–44.9 and those over 60 showing higher usage.
- Amoxicillin, azithromycin, ciprofloxacin, and cephalexin were the top-selling antimicrobials.

## Abstract

To analyze the antimicrobial dispensing profile in Brazil from 2014 to 2021 based on records from the Brazilian National System of Controlled Products Management (SNGPC) of the Brazilian Health Regulatory Agency (Anvisa).

A descriptive, time-series ecological study was carried out using data from private pharmacies and drugstores on the sale of antimicrobial drugs. Drugs sold from January 2014 to November 2021 were included, with analysis of the variables of month, year, municipality, state, active ingredient, prescriber’s professional council, and patient’s sex and age.

During the study period, 532,518,866 sales of special control drugs were recorded in SNGPC, 66.8% of which were antimicrobials. There was an increase in sales up to 2019, with a decrease in 2020, during the COVID-19 pandemic, and a new increase in 2021. The Southeast and Northeast regions concentrated the highest sales, with the Southeast leading. Sales were higher among women, especially in the 30 to 44.9 age group, with an increase in sales among patients aged 60 or older. The best-selling antimicrobials were amoxicillin, azithromycin, ciprofloxacin and cephalexin.

The study reveals differences in consumption by region, sex, and age, and it highlights the importance of educational interventions for the responsible use of antimicrobials. It also points out that the suspension of mandatory data registration in SNGPC may compromise the monitoring necessary to combat bacterial resistance and improve public health in Brazil.

Analisar o perfil de dispensação de antimicrobianos no Brasil durante o período de 2014 a 2021 com base nos registros do Sistema Nacional de Gerenciamento de Produtos Controlados (SNGPC) da Agência Nacional de Vigilância Sanitária (Anvisa).

Foi realizado um estudo ecológico descritivo, de série temporal, utilizando dados de farmácias e drogarias privadas, sobre a venda de medicamentos antimicrobianos. Foram incluídos medicamentos vendidos de janeiro de 2014 a novembro de 2021, com análise das variáveis: mês, ano, município, estado, princípio ativo, conselho de classe do prescritor, sexo e idade do paciente.

No período do estudo, foram registradas 532.518.866 vendas de medicamentos de controle especial no SNGPC, sendo 66,8% de antimicrobianos. Observou-se um aumento nas vendas até 2019, com queda em 2020, período da pandemia de COVID-19, e novo aumento em 2021. As regiões Sudeste e Nordeste concentraram as maiores vendas, com a Sudeste liderando. As vendas foram mais altas entre mulheres, especialmente na faixa etária de 30 a 44,9 anos, com um aumento de vendas em pacientes com 60 anos ou mais. Os antimicrobianos mais vendidos foram amoxicilina, azitromicina, ciprofloxacino e cefalexina.

O estudo revela diferenças de consumo por região, gênero e idade, e destaca a importância de intervenções educativas para o uso responsável de antimicrobianos. Aponta ainda que a suspensão do registro obrigatório de dados no SNGPC pode comprometer o monitoramento necessário para combater a resistência bacteriana e melhorar a saúde pública no Brasil.