Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation

Shamsuddin, Shafinaz; Akkawi, Muhammad Eid; Zaidi, Syed Tabish Razi; Ming, Long Chiau; Manan, Mohamed Mansor

doi:10.1016/j.ijid.2016.09.013

Cited by 29 publications

(33 citation statements)

References 12 publications

(11 reference statements)

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“…The most used antibiotic agent was amoxicillin, followed by amoxicillin and beta-lactamase inhibitor, levofloxacin, azithromycin, and benzylpenicillin. These results are comparable to those of a study conducted in 48 primary health care facilities sampled from six provinces in China (Wang et al, 2014) and consistent with those from other Asian countries, such as Malaysia and India (Sharma et al, 2012;Shamsuddin et al, 2016). Findings in this study showed a declining antibiotic use.…”

Section: Discussionsupporting

confidence: 90%

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

et al. 2020

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Background: The overuse of antibiotics is a serious public health problem in China, causing a high rate of antimicrobial resistance. This study identified the trends of antibiotic consumption in China to provide evidence for further intervention. Method: The six-year surveillance data on antibiotic sales from 2012 to 2017, which served as a proxy for consumption, were collected from 39 public health care facilities in Shandong province, including three tertiary hospitals, six secondary hospitals, and 30 primary health centers. Based on the Anatomical Therapeutic Chemical (ATC)/DDD methodology, antibiotic consumption was formulated in defined daily doses (DDD) per 1,000 inhabitants per day (DID). Results: The total antibiotic consumption among all health care settings increased from 16.07 DID in 2012 to a peak of 17.44 DID in 2015 and then decreased to 11.35 DID in 2017 with a 34.90% reduction. J01C (beta-lactam antimicrobials, penicillin), the most frequently used antibiotic class, accounted for 36.32% of the total DID. Consumption of carbapenems increased from 0.029 DID in 2012 to 0.08 DID in 2017. Parenteral antibiotics accounted for nearly 40% of the total consumption. Compared with the 2012 figures, the 2017 consumption showed a small increase in hospital sector that was compensated by the decrease in community care. Conclusion: A substantial reduction in total antibiotic consumption was observed in China from 2012 to 2017. However, the extensive consumption of broad-spectrum antimicrobials, high proportion of parenteral antibiotic use, and increased use of lastresort antibiotics attracted public health concerns.

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Section: Discussionsupporting

confidence: 90%

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

et al. 2020

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“…The results of our study report a 90.25% of inappropriate prescription in the Health Center that we evaluated. An estimated average of antibiotic prescription appropriateness from studies around the world, mostly including high – middle income countries, is of about 50% [ 8 , 26 – 31 ]. A review of 344 studies between 1990 and 2009 on the treatment of childhood infections in 78 low-middle income countries reported that a high percentage of viral upper respiratory tract infection cases were being treated with antibiotics, with this percentage increasing over time (from 42% before 1990 up to 72% in 2006–2009) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“Appropriateness and adequacy of antibiotic prescription for upper respiratory tract infections in ambulatory health care centers in Ecuador”

Choez

Acurio

Jimbo

2018

BMC Pharmacol Toxicol

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BackgroundUpper respiratory tract infections are the leading cause of misuse of antibiotics, a problem that leads to unnecessary adverse events and antibiotic resistance. Antibiotic prescription in Ecuador was analyzed in order to evaluate the state of antibiotic prescribing for upper respiratory tract infections. Both the appropriateness and adequacy of prescribing was evaluated. Appropriateness represents the percentage of prescriptions that are indicated; adequacy refers to the percentage of patients requiring antibiotics who are treated.MethodsThe aim of the study is to analyze the appropriateness and adequacy of antibiotic prescription for upper respiratory tract infections in the Ambulatory Health Centers of the Ministry of Public Health of Ecuador. This is a cross-sectional study of patients from one Health Center of the Ministry of Public Health in the District 17D03 in Ecuador during 2015 with upper respiratory tract infection as a primary diagnosis.ResultsWe included a total of 1393 patients in the analysis. Out of the 1393 patients identified, 523 were prescribed antibiotics, constituting an antibiotic prescription rate of 37.5%, and 51 required antibiotics, reflecting a real need of antibiotics of 3.7%. Appropriateness: Of these 523 patients who were treated, 51 required an antibiotic, resulting in an appropriate antibiotic prescription rate of 9.75%. Adequacy: When analyzing each individual case, 33 of these 51 patients received an antibiotic, constituting an adequate prescription rate of 64.7%.ConclusionsThe results of our study report a 90.25% of inappropriate prescription. The antibiotic prescription, appropriate prescription, and adequate prescription rates show the need for implementation of strategies in order to reduce them. Related aspects regarding prescriber’s behavior and the patient’s expectations should be analyzed.Electronic supplementary materialThe online version of this article (10.1186/s40360-018-0237-y) contains supplementary material, which is available to authorized users.

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“…However, the care provided in these establishments demands the integration of mental and physical care, that is, the user needs treatment for the disorder, but should also have his/her other needs met, such as an infection, so that resolute and holistic assistance is provided. (22) In terms of costs, pharmaceutical costs with antibiotics for primary care are high, a finding that is supported by other studies in Malaysia (23) and in the United States of America. (24) According to data from the Integrated System of General Services Administration (SIASG), from 2006 to 2013 there was a significant increase in pharmaceutical expenditures by the Brazilian government, with total expenditure tripled (2.72 times), while the amounts purchased only doubled (1.99) during the same period.…”

Section: Discussionmentioning

confidence: 69%

Distribuição e custo de antimicrobianos na Atenção Primária

et al. 2018

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Objective: To analyze antimicrobial distribution and costs in primary care of a capital city in the Northeast region of Brazil. Methods: Cross-sectional, analytical study, developed in the city of Teresina, in the state of Piauí, Brazil. Data cover the period from June 2015 to July 2016. Descriptive statistics and the Kruskal-Wallis test were calculated to compare the medians of the independent data distributions. Results: A total of 1,651,516 antimicrobials were distributed in 15 different types, with amoxicillin (500mg) being the most distributed (75%) in psychosocial care centers, and in the basic health units (47%). The total cost for the period was 98,705.00 BRL. There were no statistically signifi cant differences among the costs medians in each zone of the studied municipality. Conclusion: These drugs are irregularly distributed among the units, according to the demand. The supply does not follow a specifi c protocol, and a possible increase or reduction in demand is not investigated. ResumoObjetivo: Analisar a distribuição e custos de antimicrobianos na Atenção Primária de uma capital da Região Nordeste do Brasil. Método: Estudo transversal, analítico, desenvolvido em Teresina, Piauí, Brasil. Os dados contemplam o período de junho de 2015 a julho de 2016. Calculou-se estatísticas descritivas e o Teste de Kruskal-Wallis para comparar as medianas das distribuições de dados independentes. Resultados: Foram distribuídos 1.651.516 antimicrobianos de 15 tipos diferentes dos quais a amoxicilina (500mg) foi o mais distribuído (75%) nos Centros de Atenção Psicossocial e nas Unidades Básicas de Saúde (47%). O custo total no período foi de 98.705,00 reais. Não houve diferenças estatisticamente signifi cante entre as medianas dos custos em cada zona do município estudado. Conclusão: A distribuição desses medicamentos é realizada de forma irregular entre as unidades, de acordo com a demanda. O fornecimento não segue protocolo específi co, e não se investiga um possível aumento na demanda ou redução. ResumenObjetivo: Analizar la distribución y costos de antimicrobianos en Atención Primaria de una capital del Noreste de Brasil. Método: Estudio transversal, analítico, desarrollado en Teresina, Piauí, Brasil. Datos obtenidos entre junio de 2015 y julio de 2016. Se aplicó estadística descriptiva y el Test de Kruskal-Wallis para comparar las medianas de las distribuciones de datos independientes. Resultados: Fueron distribuidos 1.651.516 antimicrobianos de 15 tipos diferentes, de los cuales la amoxicilina (500mg) fue el más entregado (75%) en Centros de Atención Psicosocial y en Unidades Básicas de Salud (47%). El costo total durante el período fue de 98.705,00 Reales. No hubo diferencia estadísticamente signifi cativa entre las medianas de costos en cada zona del municipio estudiado. Conclusión: La distribución de estos medicamentos se realiza de manera irregular entre las unidades, de acuerdo a la demanda. La provisión no cumple protocolos específi cos, y no se investiga un posible aumento o reducción de demanda.

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Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation

Cited by 29 publications

References 12 publications

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

Antibiotic Consumption Trends in China: Evidence From Six-Year Surveillance Sales Records in Shandong Province

“Appropriateness and adequacy of antibiotic prescription for upper respiratory tract infections in ambulatory health care centers in Ecuador”

Distribuição e custo de antimicrobianos na Atenção Primária

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