Changing Antibiotic Utilisation Patterns in Costa Rica. Essential Drugs Monitor No. 014 (1993)
(1993; 1 page)


A study conducted in Costa Rica monitored the consumption of antibiotics in Costa Rica from 1982 to 1989 to determine whether these drugs were used rationally. Costa Rica is a small country in Central America. Approximately 95% of its three million inhabitants receive health care services through the public Costa Rican Social Security Institute. The Institute’s Department of Pharmacotherapeutics is responsible for updating the national essential drugs list regularly. The number of antibiotics and urinary tract antiseptics on the list increased from 18 in 1984 to 21 in 1985. In accordance with this increase, the consumption of antibiotics increased throughout Costa Rica from 1982 to 1989 with a notable change in consumption patterns for the last two years of the study. A study released in 1985 showed that between 68% and 97% of gram negative bacilli were resistant to ampicillin. Prescribers were informed of this data and told to prescribe nitrofurantoin and cortimoxazole instead of ampicillin. However, consumption of ampicillin, nitrofurantoin, and cortimoxazole remained constant while consumption of cefalexin increased in 1988 and 1989. This trend clearly showed that cefalexin became the prescribers’ preferred substitute for ampicillin despite recommendations of nitrofurantoin and cortimoxazole. This study raised concerns about prescribers’ habits and the rational use of medicines throughout Costa Rica. (Abstract by Flannery Bowman)

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