Consumption of systemic antibiotics in India in 2019

Koya, Shaffi Fazaludeen; Ganesh, Senthil; Selvaraj, Sakthivel; Wirtz, Veronika J.; Galea, Sandro; Rockers, Peter C.

doi:10.1016/j.lansea.2022.100025

Cited by 29 publications

(25 citation statements)

References 21 publications

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“…Study area map was made using QGIS v3. 10 which is an open-source software freely available on the internet.…”

Section: Discussionmentioning

confidence: 99%

“…According to a recent study in India, it is reported that the total defined daily doses (DDD) was 5,071 million in 2019 and the defined daily doses per 1,000 people per day (DID) was 10.4. Azithromycin was the most consumed antibiotic molecule (12.6%) followed by cefixime (10.2%) (10). As per the scoping report in 2017, more than 70% of the isolates of the Gram-negative bacteria, i.e., Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii as well as almost half of all Pseudomonas aeruginosa were resistant to fluoroquinolones and third generation cephalosporins.…”

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confidence: 98%

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Perception and determinants leading to antimicrobial (mis)use: A knowledge, attitude, and practices study in the rural communities of Odisha, India

Pattnaik

Nayak

Karna

et al. 2023

Front. Public Health

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BackgroundAntimicrobial resistance (AMR) has emerged as one of the major public health issues globally. This cross-sectional study determined knowledge, attitudes and practices (KAP) regarding antimicrobial use and AMR among rural communities of Tigiria (Odisha), India.MethodsA semi-structured questionnaire based on socio-demographic characteristics, antibiotics usage, awareness of antimicrobial resistance, healthcare utilization and quality of life were asked to the participants using an electronic device with Open Data Kit. Descriptive statistics, independent t-test and ANOVA were performed to analyze the variables.ResultsA total of 1,003 participants were surveyed in the study from 25 villages of Tigiria. About 44.47% (95% CI: 41.36–47.60) of study participants have heard about antimicrobial medicines and 14.75% (95% CI: 12.65–17.13) of participants were involved in buying antibiotics without prescription over the counter. Around 20.14% (95% CI: 17.72–22.78) of participants, stopped taking antibiotics before completing the full course. The physical domain was the most affected with low scores compared to other domains of quality of life (QOL). The QOL scores were found significant (p < 0.05) across age, gender, education and ethnicity.ConclusionThe study documented a significant level of KAP regarding antimicrobial (mis)use in the study. It is essential that antimicrobial stewardship programs for various stakeholders and educational programmes must be initiated to increase awareness of people on antimicrobial resistance.

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“…Study area map was made using QGIS v3. 10 which is an open-source software freely available on the internet.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

Perception and determinants leading to antimicrobial (mis)use: A knowledge, attitude, and practices study in the rural communities of Odisha, India

Pattnaik

Nayak

Karna

et al. 2023

Front. Public Health

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“…Inapposite use of antibiotics directly trigger antibiotic resistance in India due to the lack of official monitoring of antibiotic usage. Largely unrestricted over-the-counter sales of most antibiotics complicate antibiotics availability, sales, and consumption in the country [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation of a simple PCR assay and nested PCR for rapid detection of clarithromycin-resistant Helicobacter pylori from culture and directly from the biopsy samples in India

et al. 2023

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Background Eradication of Helicobacter pylori provides the most effective treatment for gastroduodenal diseases caused by H. pylori infection. Clarithromycin, a member of the macrolide family, still remains the most important antibiotic used in H. pylori eradication treatment. But the increasing prevalence of clarithromycin resistant H. pylori strains due to point mutations in the V region of the 23S rRNA, poses a great threat in treating the ailing patients. So, we aimed for PCR-mediated rapid detection of the point mutation at 2143 position of 23S rRNA gene in H. pylori that is relevant to clarithromycin resistance from culture and simultaneously from biopsy specimens to avoid the empirical treatment. Results Newly developed PCR assay using DNA of pure culture detected point mutation in 23S rRNA gene in 21 (8.04%) of 261 clinical strains tested. The agar dilution method showed that all these 21 strains were resistant to clarithromycin indicating the perfect match of the PCR based results. Additionally, the sequencing study also identified the A to G mutation at 2143 position in 23S rRNA gene of the resistant strains only. Consequently, the newly developed Nested-ASP-PCR dealing directly with 50 biopsy specimens demonstrated 100% sensitivity and specificity with the findings of agar dilution method taken as Gold standard. Bioinformatics based analysis such as accessibility analysis and dot plot clearly stated that the base pairing probability has increased due to mutation. Computational studies revealed that the point mutation confers more stability in secondary structure due to conversion of loop to stem. Furthermore, interaction studies showed binding affinity of the CLR to the mutant type is weaker than that to the wild type. Conclusion This assay outlines a rapid, sensitive and simple approach to identify point mutation that confers clarithromycin resistance as well as clarithromycin sensitive strains, providing rapid initiation of effective antibiotic treatment. Additionally, it is simple to adopt for hospital based diagnostic laboratories to evaluate the degree of regional clarithromycin resistance from biopsy specimens itself. Furthermore, in silico studies provide evidence or a signal that the prevalence of clarithromycin resistance may rise in the near future as a result of this point mutation.

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“…Similar trend was seen a study conducted in India. 10 But from other regions of WHO Southeast Asia Region, it can be seen that amoxicillin is the most commonly used, then only followed by macrolides. 5 This can be attributed to the fact that in since azithromycin is one of the antibiotics prescribed preliminarily, more people are aware of the medicine.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic self-medication-prevalence and trends among adults attending an urban health centre in South Kerala

Mohanlal

Eliza

Nair

et al. 2022

Int J Community Med Public Health

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Background: Antibiotics acts as an essential tool, especially in the developing world where infectious diseases are the major cause of mortality. But widespread inappropriate use of antibiotics has been identified as the major reason for antimicrobial resistance. Objectives were to estimate the prevalence of antibiotic self-medication among adults attending an urban health centre in South Kerala and to assess the trends of antibiotic self-medication in the study groupMethods: This cross-sectional study was conducted among community dwelling adults attending the health centre which covers the urban field practice area of Pushpagiri institute of medical sciences, Tiruvalla. Data was collected using interviewer administered questionnaire from adults aged 18 years and above using consecutive sampling methodResults: Out of 236 participants, 138(58.5%) were females and 98 (41.8%) males. The mean age of the study population was 50.10±18.27 SD. Overall prevalence of antibiotic self-medication among the study group was 12.7%. In our study, age group (p<0.001), education (p<0.001) and socio-economic status (p<001) were significantly associated with antibiotic self-medication. The most common drug among study population was azithromycin (66.7%).Conclusions: Even though the overall prevalence of antibiotic self-medication was low among community dwelling adults in South Kerala, higher rates were seen in a certain stratum of the population. The study necessitates the need for better understanding of the effects of antibiotic self-medication which can be done through effective strategies like behavior change communication and promoting further research into the cause and effects of antibiotic self-medication

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Consumption of systemic antibiotics in India in 2019

Cited by 29 publications

References 21 publications

Perception and determinants leading to antimicrobial (mis)use: A knowledge, attitude, and practices study in the rural communities of Odisha, India

Perception and determinants leading to antimicrobial (mis)use: A knowledge, attitude, and practices study in the rural communities of Odisha, India

Development and evaluation of a simple PCR assay and nested PCR for rapid detection of clarithromycin-resistant Helicobacter pylori from culture and directly from the biopsy samples in India

Antibiotic self-medication-prevalence and trends among adults attending an urban health centre in South Kerala

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