Antibiotic prescribing and antibiotic resistance in community practice: retrospective study, 1996-8

Magee, J. T.; Pritchard, E. L.; Fitzgerald, Karen A.; Dunstan, Frank David John; Howard, Anthony

doi:10.1136/bmj.319.7219.1239

Cited by 166 publications

(93 citation statements)

References 2 publications

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“…This is comparable by a study done in Gambia in which few medicines were prescribed per each encounter. [22] Our results did not deviate much from previous WHO study in Tanzania where an average of 2.2 medicines was prescribed per patient. [9] Essential medicines list and generic prescribing are commonly used in drug utilization interventions across the globe for healthcare cost reduction.…”

Section: Discussioncontrasting

confidence: 50%

Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania

Irunde¹,

Minzi²,

Moshiro³

2017

JPPCM

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Objective: The purpose of the study was to measure rational medicines prescribing in healthcare facilities from selected regions in Tanzania was found to be 18.1% while that containing antibiotics was 67.7% and the average number of medicines per prescription was 2.3. The proportion of medicines prescribed by generic was 95.7%while one that contained medicines in line with the National Essential Medicines List was 96.7%. The overall IRDP for the current study was 3.81with optimal level of 5. Kilimanjaro region scored highest IRDP (3.35) while Mbeya region scored the least (IRDP of 3.11). Rural healthcare facilities scored low IRDP (3.25) while for urban facilities IRDP was higher (3.42). IRDP for public healthcare facilities was higher (3.65) than for private facilities (3.02). Conclusion: Rational drug prescribing in Tanzania is not yet optimal leading to over-prescribing of antibiotics and injections.

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Section: Discussioncontrasting

confidence: 50%

Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania

Irunde¹,

Minzi²,

Moshiro³

2017

JPPCM

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“…It is generally accepted that the main cause of this problem has been and still is widespread inappropriate use and overprescribing of antibiotics in clinical medicine, animal husbandry, and veterinary practice (71,86,79,170,225,274). Concern about bacterial resistance has led to calls for increased education of both the public and professionals on the correct use of antibiotics and more stringent infection control measures to reduce the transmission of infection (68,83,111,214,304; G. Delage, final recommendations, Global Consensus Conference on Infection Control Issues Related to Antimicrobial Resistance, 1999, p. 503-513; J. C. Wright, Association Internationale de la Savonnerie press response to antibiotic resistance, www.pestlaw.net/x/press/2000/ ncis-20000300A.html, 1999).…”

Section: Introductionmentioning

confidence: 99%

Potential Impact of Increased Use of Biocides in Consumer Products on Prevalence of Antibiotic Resistance

2003

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There has recently been much controversy surrounding the increased use of antibacterial substances in a wide range of consumer products and the possibility that, as with antibiotics, indiscriminate use of biocides might contribute to the overall pattern of susceptibility in the general environment and in the clinic. Such speculation, based on the isolation of resistant mutants from in vitro monoculture experiments, is not reflected by an emergence of biocide-resistant strains in vivo. This review provides a broad coverage of the biocide and resistance literature and evaluates the potential risks, perceived from such laboratory monoculture experiments, against evidence gathered over 50 years of field studies. An explanation for the continued effectiveness of broad-spectrum biocidal agents against the decline in efficacy of therapeutic agents is provided based on the fitness costs of resistance and the ubiquity of naturally occurring substances that possess antibacterial effect. While we conclude from this review of the literature that the incorporation of antibacterial agents into a widening sphere of personal products has had little or no impact on the patterns of microbial susceptibility observed in the environment, the associated risks remain finite. The use of such products should therefore be associated with a clear demonstration of added value either to consumer health or to the product life. Hygienic products should therefore be targeted to applications for which the risks have been established

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“…For example, a study from Wales showed an association between rates of GP antibiotic prescribing and trimethroprim resistance in urinary tract infections. 15 In Finland, an increase in erythromycin prescribing was associated with an increase in erythromycin resistance in group A streptococci isolates. When erythromycin prescribing subsequently fell, so did resistance.…”

Section: Does My Practice Influence the Development And Spread Of Resmentioning

confidence: 99%

Is antibiotic resistance a problem? A practical guide for hospital clinicians

Barlow

Nathwani²

2005

Postgraduate Medical Journal

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Antibiotic resistance is an important concern for patients, physicians, healthcare managers, and policymakers. Inappropriate antimicrobial prescribing fuels the evolution of resistance, while poor basic hygiene facilitates the spread of resistant microbes between patients and healthcare staff. The development of infection with a resistant pathogen may lead to poorer health and economic outcomes. The problem for the frontline clinician, however, is how to balance the responsibility of prudent prescribing with the risk of sub-optimally treating a patient who may be infected with a resistant pathogen. This article discusses how hospital physicians can use severity and risk factor assessment, and knowledge of local microbial epidemiology, to guide empiric antibiotic prescribing. Most patients hospitalised with a community acquired bacterial infection in the UK can still be managed with a traditional first line antibiotic(s). In contrast, regimens that account for resistance are often required in patients with hospital acquired infections, particularly if the patient is critically ill.

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Antibiotic prescribing and antibiotic resistance in community practice: retrospective study, 1996-8

Cited by 166 publications

References 2 publications

Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania

Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania

Potential Impact of Increased Use of Biocides in Consumer Products on Prevalence of Antibiotic Resistance

Is antibiotic resistance a problem? A practical guide for hospital clinicians

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