Outpatient Antimicrobial Utilization and Communicable Disease Trends in a Secondary Care Hospital in Eastern Sri Lanka:  A 13-Month Retrospective Pharmacoepidemiological Study

Kunalinee Sevaraj 1, *, Kathiresapillai Tharshanan 2 and Gunasingam Sukunan 3

1 Base Hospital Mahaoya, Sri Lanka.
2 Ministry of Health, Sri Lanka.
3 Base Hospital Kalmunai North, Sri Lanka.
* Corresponding Author
ORCID Details

 

Research Article
International Journal of Science and Technology Research Archive, 2026, 11(01), 039–051.
Article DOI: 10.53771/ijstra.2026.11.1.0031
Publication history: 
Received on 14 July 2026; revised on 20 August 2026; accepted on 22 August 2026
 
Abstract: 
Background: Antimicrobial agents have transformed the management of infectious diseases and remain among the most frequently prescribed medicines worldwide. However, inappropriate utilization of antimicrobials has become one of the principal drivers of antimicrobial resistance (AMR), threatening the effectiveness of modern healthcare. The outpatient setting accounts for a substantial proportion of antimicrobial consumption, making it an important focus for antimicrobial stewardship interventions. Although Sri Lanka has strengthened national policies on antimicrobial stewardship and AMR containment, evidence describing outpatient antimicrobial utilization, particularly in secondary care hospitals, remains limited. Furthermore, few studies have attempted to interpret antimicrobial utilization alongside local communicable disease epidemiology.
Objective: To describe the pattern of outpatient antimicrobial utilization at Base Hospital, Maha Oya over a thirteen-month period.
Methods: A retrospective descriptive pharmacoepidemiological study was conducted using routinely maintained pharmacy dispensing records of the Outpatient Department (OPD) at Base Hospital Maha Oya, Sri Lanka. Monthly utilization data for all antimicrobial medicines, including antibacterial, antiviral and antifungal agents, dispensed between June 2025 and June 2026 were extracted and analysed. Quarterly communicable disease surveillance reports covering the corresponding period were reviewed to summarize disease trends within the hospital's catchment area. Descriptive statistics were used to summarize antimicrobial utilization, while temporal comparisons between quarterly antimicrobial utilization and communicable disease notifications were performed descriptively.
Results: During the study period, 34 antimicrobial preparations comprising antibacterial, antiviral and antifungal agents were dispensed through the outpatient pharmacy. Antibacterial agents constituted the largest proportion of overall antimicrobial utilization, with amoxicillin and co-amoxiclav being the most frequently utilized medicines. Monthly utilization demonstrated noticeable temporal variation throughout the study period. Communicable disease surveillance data identified chickenpox, dengue fever, leptospirosis and tuberculosis as the predominant notifiable diseases reported within the hospital catchment area.
Conclusion: This study provides baseline evidence regarding outpatient antimicrobial utilization in a secondary care hospital in Sri Lanka and demonstrates the value of integrating pharmacy utilization data with communicable disease surveillance. The findings highlight opportunities for strengthening antimicrobial stewardship programmes, promoting rational antimicrobial use, and supporting evidence-based prescribing policies within secondary healthcare institutions.
 
Keywords: 
Antimicrobial utilization; Drug utilization study; Pharmacoepidemiology; Antimicrobial stewardship; Antimicrobial resistance; Communicable diseases; Sri Lanka
 
Full text article in PDF: 
 
Copyright information: 
Copyright © 2026 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0