Antibiotic Resistance: Challenges and Prospect for Therapy in Developing Countries

Tula, M. Y.; Iyoha, O; Iruolaje, F. O.

doi:10.9734/bjpr/2015/19061

Cited by 5 publications

(6 citation statements)

References 52 publications

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“…A growing number of infections are becoming harder to treat as the bacteria that were supposed to be killed by antibiotics are developing different resistance patterns to the medication [ 3 ]. Importantly, resistance to the most commonly available antibiotics has been increasing sharply in recent years as a direct consequence of irrational use of antibiotics [ 4 , 5 ]. An estimated 700,000 people die of AMR each year worldwide [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pattern of Antibiotic Dispensing at Pharmacies According to the WHO Access, Watch, Reserve (AWaRe) Classification in Bangladesh

et al. 2022

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The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate antibiotic stewardship and optimal use. In Bangladesh, data on antibiotic dispensing in pharmacies according to the AWaRe classification are scarce. We aimed to explore antibiotic dispensing pattern in pharmacies according to the WHO AWaRe classification to aid pharmacy-targeted national antibiotic stewardship program (ASP). From January to July 2021, we interviewed drug-sellers from randomly selected pharmacies and randomly selected customers attending the pharmacies. We collected data on demographics and medicines purchased. We classified the purchased antibiotics into the Access, Watch, and Reserve groups among 128 pharmacies surveyed, 98 (76.6%) were licensed; 61 (47.7%) drug-sellers had pharmacy training. Of 2686 customers interviewed; 580 (21.6%) purchased antibiotics. Among the 580 customers, 523 purchased one, 52 purchased two, and 5 purchased three courses of antibiotics (total 642 courses). Of the antibiotic courses, the Watch group accounted for the majority (344, 53.6%), followed by the Access (234, 36.4%) and Reserve (64, 10.0%) groups. Approximately half of the antibiotics (327/642, 50.9%) were purchased without a registered physician’s prescription. Dispensing of non-prescribed antibiotics was higher in the Access group (139/234, 59.4%), followed by Watch (160/344, 46.5%) and Reserve (28/64, 43.8%) groups. These findings highlight the need to implement strict policies and enforce existing laws, and pharmacy-targeted ASP focusing on proper dispensing practices to mitigate antimicrobial resistance in Bangladesh.

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Section: Introductionmentioning

confidence: 99%

Pattern of Antibiotic Dispensing at Pharmacies According to the WHO Access, Watch, Reserve (AWaRe) Classification in Bangladesh

et al. 2022

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“…Although antibacterial resistance is a natural phenomenon, human factors exacerbate its emergence and spread [1]. One of the major factors that greatly influences the development of resistance is the irrational use of antibiotics [2, 3]. Irrational use of antibiotics can take many forms, including the use of too many medicines per patient (polypharmacy), the inappropriate use of self-medication (often with prescription-only medicines), in non-bacterial infections, outside clinical guidelines, or with inadequate dosage or inappropriate route of administration such as overuse of injections when oral formulations would be more appropriate [2, 4].…”

Section: Introductionmentioning

confidence: 99%

“…One of the major factors that greatly influences the development of resistance is the irrational use of antibiotics [2, 3]. Irrational use of antibiotics can take many forms, including the use of too many medicines per patient (polypharmacy), the inappropriate use of self-medication (often with prescription-only medicines), in non-bacterial infections, outside clinical guidelines, or with inadequate dosage or inappropriate route of administration such as overuse of injections when oral formulations would be more appropriate [2, 4]. All these factors expose bacteria to sub-optimal levels of antibiotics, which is not only therapeutically ineffective but also facilitates the formation of resistance against the drug by the bacteria [1].…”

Section: Introductionmentioning

confidence: 99%

Irrational use of antibiotics in the Moshi Municipality Northern Tanzania: a cross sectional study

Mboya¹,

Sanga²,

Ngocho³

2018

Pan Afr Med J

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Introduction Irrational use of antibiotics includes prescription of incorrect doses, self-medication and treatment of non-bacterial illness. As a direct consequence of irrational antibiotic use, resistance to the commonly available antibiotics has been increasing rapidly. This phenomenon is associated with poorer health outcomes, longer hospitalization, increased cost to both the patient and government, and increased mortality. The aim of this study was to determine the prevalence of, and examine factors associated with, irrational use of antibiotics in the Moshi municipality, Northern Tanzania. Methods We conducted a cross-sectional descriptive study between April and May 2017 in the Moshi municipality. Twelve drug outlets, of which five were pharmacies and seven accredited drug dispensing outlets (ADDOs), were selected at random. On exiting these outlets, all adults who had purchased antibiotics were interviewed using structured questionnaires. Results A total of 152 adults were enrolled in this study. The median (QR) age was 31 years (25-42). The majority, 94 (61.8%), of the participants were female. ADDOs contributed 81 (53.3%) and pharmacies contributed 71 (46.7%) of all participants. Overall, 135 (88.8%) of antibiotic purchases were irrational. The most prevalent form of irrational antibiotic use was non-prescription usage; 116 of the 152 (76.3%) purchases fell in this category. Purchases of the incomplete dosage and purchases for non-bacterial illness were also widespread. Poor knowledge about the use of antibiotics had a significant association with irrational use of antibiotics (aOR=5.1, 95% CI: 1.80-15.15). Conclusion Irrational use of antibiotics is highly prevalent in this population. Non-prescription use of antibiotics is the most prevalent form. Poor knowledge about antibiotic use plays a significant role in irrational antibiotic use. There is a need to review the accessibility of antibiotics in drug outlets.

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“…This is brought about by the lack of effective antibiotic stewardship which as a result enhances the easy accessibility of drugs and drug outlets even without the recommendations of qualified and authorized medical personnel. This subsequently leads to the haphazard use of antimicrobials [49,61].…”

Section: Discussionmentioning

confidence: 99%

A Systematic review on the status of diarrheagenic Escherichia coli (DEC) pathotypes in Nigeria; the year 2000 – 2022

Tula¹,

Filgona²,

Pukuma³

2022

Cell. Mol. Biomed. Rep.

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This systematic review appraised the current status of DEC in Nigeria from the year 2000 to August 2022 with regards to their prevalence, pathotypes distribution, and dominance within the 6 geopolitical zones. Three research databases (AJOL, PubMed, and Google Scholar) were explored for articles of interest. From the outcome of the search, 19 full-length research articles from January 2000 to August 2022 that described the prevalence of DEC by molecular technique were recruited into the study. The results show that the studies of DEC were higher in the southern (52.63%) than in the northern (47.37%) region. Based on specimen types, 47.37% (9/19) and 52.63% (10/19) articles documented DEC from non-clinical and clinical sources, respectively. From the clinical sources, 70% of the studies targeted children of less than five years of age for the detection of DEC. The mean prevalence of DEC in Nigeria stands at 18.8%. The regional prevalence varies with the highest in the SW (32.57%) and the lowest in the NC (10.07%). The relationship between the prevalence of DEC to age group, gender, sample sources (clinical or non-clinical), study design (experimental and control groups), and regional differences were examined using odd ratios and chi-square statistics. Significance differences (P=0.0001) were obtained for all the parameters except gender which shows a lack of significant difference (P=0.1129). The most prevalent DEC pathotype was EAEC pathovar (44.62%) and the least was DAEC (2.23%). The regional distribution of the DEC pathotypes varies with the type of sample (clinical and non-clinical). Hybrid pathotypes were detected and constitute 4.89 % of the total DEC detected. The most prominent hybrid detected was EAEC/ETEC (39.13%). In that order, the DEC pathotypes were mostly resistant to ampicillin, penicillin, cotrimoxazole, and tetracycline, but were mostly susceptible to imipenem, gentamycin, and ofloxacin. We, therefore, advocate regular or periodic surveillance of DEC, and their drug resistance pattern, which will be useful to clinical personnel in their choice of a treatment regimen. Article info

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Antibiotic Resistance: Challenges and Prospect for Therapy in Developing Countries

Cited by 5 publications

References 52 publications

Pattern of Antibiotic Dispensing at Pharmacies According to the WHO Access, Watch, Reserve (AWaRe) Classification in Bangladesh

Pattern of Antibiotic Dispensing at Pharmacies According to the WHO Access, Watch, Reserve (AWaRe) Classification in Bangladesh

Irrational use of antibiotics in the Moshi Municipality Northern Tanzania: a cross sectional study

A Systematic review on the status of diarrheagenic Escherichia coli (DEC) pathotypes in Nigeria; the year 2000 – 2022

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