exploration of doctors' antibiotic use practices and possible interventions will be helpful in carrying out interventions to promote appropriate use of antibiotics in the community.

Inappropriate antibiotic dispensing and use owing to commercial interests and lack of knowledge about the rational use of antibiotics and antibiotic resistance were the main findings of this in-depth qualitative study. Community pharmacists were willing to participate in educational programme aimed at improving use of antibiotics. Such programmes should be initiated within a multidisciplinary framework including doctors, pharmacists, social scientists, government agencies and non-profit organizations.

OBJECTIVE:The objective of the study was to explore the prescribing practices, knowledge, and attitudes of primary care doctors and community pharmacists, regarding antibiotic use in acute upper respiratory tract infections (URTI) and diarrhea in children to better understand causes of misuse and identify provider suggestions to change such behavior.MATERIALS AND METHODS:Two focus group discussions (FGDs) each were conducted with primary care government doctors (GDs), private general practitioners (GPs), pediatricians, and community pharmacists in Delhi. Each FGD had 8–12 participants and lasted 2 h. Furthermore, 22 individual face-to-face semi-structured interviews were conducted with providers of varying type and experience at their workplaces. Thematic and summative qualitative content analysis was done.RESULTS:All groups admitted to overusing antibiotics, GPs appearing to use more antibiotics than GDs and pediatricians for URTI and diarrhea in children. Pharmacists copy the prescribing of neighborhood doctors. Antimicrobial resistance (AMR) knowledge was poor for all stakeholders except pediatricians. Causes for prescribing antibiotics were patient pressure, profit motive, lack of follow-up and in addition for GDs, workload, no diagnostic facility, and pressure to use near-expiry medicines. Knowledge was gained through self-experience, copying others, information from pharmaceutical companies, and for some, training, continuous medical education/conferences. All groups blamed other professional groups/quacks for antibiotic overuse. Interventions suggested were sensitizing and empowering prescribers through training of providers and the public about the appropriate antibiotic use and AMR and implementing stricter regulations.CONCLUSIONS:A package of interventions targeting providers and consumers is urgently needed for awareness and change in behavior to reduce inappropriate community antibiotic use.

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Objective:To explore the perceptions and knowledge of school teachers and students about antibiotic use, resistance, and suggestions for practical interventions for the rational use of antibiotics.Methodology:Five focus group discussions (FGDs) with high school students (Class: 9–11) and five with teachers were conducted in two private and three public schools (one teacher and one student FGD per school) in five municipal wards of Delhi. Qualitative data on antibiotic knowledge, resistance, and behaviors with respect to antibiotics use were collected. There were 4–8 persons per teacher FGD and 15–20 persons per student FGD. FGDs were analyzed using “thematic analyses.”Results:Students had poor knowledge regarding antibiotics and antibiotic resistance, while only some teachers had a basic understanding. Four broad themes needing attention emerged: definition of antibiotic and antibiotic resistance, antibiotic use behavior, doctor–patient relationship, and interventional strategies suggested to curtail the misuse of antibiotics and to spread awareness. In order to tackle these problems, both groups suggested a multipronged approach including robust public awareness campaigns also involving schools, better doctor–patient relationships, and stronger regulations.Conclusions:Although students and teachers exhibited poor knowledge about antibiotic use and resistance, they were keen to learn about these issues. School education programs and public education could be used to shape correct perceptions about antibiotic use among all stakeholders including children. This may help in the containment of antibiotic resistance and thus preservation of antibiotics for future generations.

DOI: http://dx.doi.org/10.3126/hprospect.v11i0.7439 Health Prospect 2012;11:61-62

aspect, evaluation criteria and schemes of HTA system. Based on analytic hierarch process (AHP) methods, We make interviews with health officials, health care providers and customers by using the AHP questionnaire. Fuzzy multiple criteria decision making (Fuzzy MCDM) was adopted to proceed the empirical evidence analysis and evaluation on the schemes of HTA systems. RESULTS: A total of 65 participants were included in this survey. Three category's aspect, twelve evaluation criteria and three schemes of HTA system were generated. For the category's aspect, the sequence of importance is 'To meet the expectations of health care providers', then 'To satisfy the requirements of customer' and the last is 'To accomplish the coverage policy of government' (0.375, 0.337 and 0.238, respectively). The deviation of balancing weight among these three aspects is little and the importance is very similar. The effective score of HTA systems, which is evaluated and selected by whole interviewers, the sequence from large to small is 'system of safety and efficacy', 'system of ethical standards', and 'system of cost effectiveness' (67.18, 61.41 and 58.01, respectively). CONCLUSIONS: The 'system of cost effectiveness' is not suitable to adopt at current stage. It does not meet the expectations from health care stakeholders if there is only one HTA system. The Bureau of National Health Insurance should select 'system of safety and efficacy' as the basis to establish a new, proper HTA system in Taiwan. OBJECTIVES:The US Food and Drug Administration (FDA) has classified drugs used in pregnancy into five categories namely A, B, C, D and X with category A being the safest and category X being absolutely contraindicated in pregnancy based on fetal risk associated with these medications. The objective of the study was to determine the time trend and predictors of FDA's category D and X drugs among outpatient visits in pregnant women. METHODS: A retrospective study using the 1997-98

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