Patterns of antibiotic use in the community and challenges of antibiotic surveillance in a lower-middle-income country setting: a repeated cross-sectional study in Vellore, south India

Abstract

Patterns of antibiotic use varied across health facilities, suggesting that interventions should involve all types of health facilities. Although challenges were encountered, our study shows that it is possible to develop surveillance systems in LMICs and the data generated may be used to plan feasible interventions, assess impact and thereby contain resistance.

Cephalosporin-3G, Highly Prescribed Antibiotic to Outpatients in Rajshahi, Bangladesh: Prescription Errors, Carelessness, Irrational Uses are the Triggering Causes of Antibiotic Resistance

“…A survey conducted in South India showed that among 52,788 outpatients about 40.9% were prescribed with antibiotics (Chandy et al, 2013) but here in Bangladesh in this study 54.36% of outpatients were ordered with antibiotics (Table 1) which is significantly higher than India. Fluoroquinolones and penicillins were widely used antibiotics in South India and cephalosporins were more often used in urban private hospitals (Chandy et al, 2013). Another survey conducted on outpatients in Nepal had shown that 46.1% patients were male and 53.9% female (Lamichhane et al, 2006).…”

“…Cephalosporin usage is highest in urban hospitals and pharmacy shops in India than rural hospitals (Chandy et al, 2013). A survey conducted in South India showed that among 52,788 outpatients about 40.9% were prescribed with antibiotics (Chandy et al, 2013) but here in Bangladesh in this study 54.36% of outpatients were ordered with antibiotics (Table 1) which is significantly higher than India. Fluoroquinolones and penicillins were widely used antibiotics in South India and cephalosporins were more often used in urban private hospitals (Chandy et al, 2013).…”

“…Very recently, a study conducted on blood cultures for Salmonella enterica suggested that fluoroquinolones should not be used for the treatment of enteric fever in Nepal (Arjyal et al, 2016). Cephalosporin usage is highest in urban hospitals and pharmacy shops in India than rural hospitals (Chandy et al, 2013). A survey conducted in South India showed that among 52,788 outpatients about 40.9% were prescribed with antibiotics (Chandy et al, 2013) but here in Bangladesh in this study 54.36% of outpatients were ordered with antibiotics (Table 1) which is significantly higher than India.…”

“…The control and regulation measures for the sale of antibiotics in developing countries are often insufficient that not only affect Bangladesh but also other developing countries throughout the world (Borg and Scicluna, 2002;Al-Bakri et al, 2005;Mitsi et al, 2005;Nakajima et al, 2010). Therefore, research is needed to evaluate the specific antibiotic usage patterns in developing countries so that educational efforts on a national basis can be developed and implemented, such as public information campaigns, educational interventions, strict enforcement of over-the-counter drug availability, establishment of evidence-based clinical practices for doctors with regular medical audit and lastly, it is essential to share information about appropriateness of antibiotic use between health professionals and patients, together with strict implementation of the laws (Chan and Tang, 2006;Barah and Goncalves, 2010) to ensure that patients receive the best quality of health care.…”

Antibiotic trends in acute febrile illness

“…Rural hospitals used co-trimoxazole more often and urban private hospitals used cephalosporins more often; 41.1% of antibiotic prescriptions were for respiratory infection. 13 Pasha et al in their study reviewed 250 cases to evaluate the prescribing pattern of antibiotics in the treatment of various types of infection found that majority of the patients were treated with Quinolones (36.55%), the major route of drug administration employed was oral route. The most common were ciprofloxacin, amoxicillin, metronidazole, ampicillin, aminoglycosides, macrolide antibiotics, cephalosporin and sulphonamides.…”