Use of Antimicrobial Agents in Consumer Products

Emergence of resistance to antibacterial agents: the role of quaternary ammonium compounds—a critical review

“…The American Medical Association has called for the removal of antibacterial agents in hygiene and cleaning products that have exhibited induction of antibiotic resistance [138]. Similarly, European regulations have evolved from n • 1451/2007 (4 December 2007) to the European decision (2008/809/CE-14 October 2008) to restrict the use of numerous active substances.…”

Assessing the impact of national antibiotic campaigns in Europe

“…3 Some of these countries implemented policy interventions to reduce antibiotic consumption during the period considered; other countries did not adopt any type of public campaign. 4 Figure 3 provides an illustration of the adoption of national campaigns to improve antibiotic use in Europe. We refer the reader to section 4 for details about the construction of this …gure.…”

“…Looking at di¤erences in the outcomes 3 Data are reliable and exhibit a good degree of comparability since the ESAC network screens for detection bias in sample and census data, bias by over-the counter sales and parallel trade, errors in assigning medicinal product packages to the Anatomical Therapeutic Chemical Classi…cation (ATC), and errors in calculations of de…ned daily doses [20]. 4 Public campaigns and policies are used interchangeably throughout the remaining of the paper. The reader should be aware that public campaigns represent a subset of possible antibiotic policies.…”

“…Antimicrobials may lose e¤ectiveness since they are frequently prescribed for viral infections [1] or can be obtained without an o¢ cial medical prescription [2,3]. Large volumes of antimicrobials are also used in agriculture and veterinary medicine, and in many consumer products where bene…ts are often unclear [4]. As illustrated in Figure 1, di¤erences across European countries in antibiotic prescribing practices measured in de…ned daily doses per 1,000 inhabitants (DID) partially mirror di¤erences in the levels of bacterial resistance captured by the rate of penicillin-non-susceptible Streptococcus pneumoniae isolates (PNSP) [5,6].…”

Antimicrobial Resistance and its Containment in Developing Countries

“…Several suggestions have been made (Burke, 2002;Coast and Smith, 2003;Kettler, 2000;Schwartz et al, 1997;Lees and Shojaee, 2002;Wise, 2002) although there is absence of good published evidence concerning cost-effectiveness in reducing emerging resistance (Wilton et al, 2002). Containment will depend on coordinated interventions that simultaneously target the behaviour of providers and patients, and change important features of the environment in which they interact, as well as managerial and policy issues which have been well articulated (Barrett, 2000;Dagan et al, 2001;de Man et al, 2000;Gruson et al, 2000;Hooton and Levy, 2001;Murthy, 2001;Poole, 2001;Samaranayake and Johnson, 1999;Schwartz et al, 1997;Schwarz et al, 2001;Sehgal, 1999;Semjen, 2000;Sirinavin et al, 1998;Slots, 1999;Smith, 1999;Tan et al, 2002;Weinstein, 2001;Wise, 2002).…”