OBJECTIVE: To investigate the feasibility of surveillance of antimicrobial use in the community in resource-constrained settings. Overuse and misuse of antimicrobial medicines is contributing to the development of resistance. The WHO Global Strategy for Containment of Antimicrobial Resistance recommends surveillance of use at all levels of the health sector but this is not done in most low and middle income countries. METHODS: Pilot projects were established in three sites in India (Delhi, Mumbai and Vellore) and 2 in South Africa (Brits and Durban). Antimicrobial use data were collected monthly from both public and private facilities. Each pilot site sought to document 30 patient encounters where antimicrobials were provided from 7 to 30 facilities per month. Antimicrobial use was expressed as the percentage of patients receiving a specific antimicrobial and as the number of defined daily doses of each specific antibiotic per 100 patients attending the facility per month. RESULTS: In all sites, there was extensive use of antimicrobials, with older agents being used more in the public sector and newer agents in the private sector. Although methodological differences limit the comparability of data, use appeared to be higher in India than in South Africa. Expressing antimicrobial use as the percentage of patients receiving a specific antimicrobial was more easily computed. Defined daily dose measure was useful in demonstrating differences in dosing and duration. CONCLUSION: All pilot sites provided data on antimicrobial use but also raised several issues related to methodology and logistics of long-term surveillance in community settings under resource constraints. Use measured as percentage of prescriptions is easier and more reliable in these settings.
OBJECTIVE: To investigate the feasibility of surveillance of antimicrobial use in the community in resource-constrained settings. Overuse and misuse of antimicrobial medicines is contributing to the development of resistance. The WHO Global Strategy for Containment of Antimicrobial Resistance recommends surveillance of use at all levels of the health sector but this is not done in most low and middle income countries. METHODS: Pilot projects were established in three sites in India (Delhi, Mumbai and Vellore) and 2 in South Africa (Brits and Durban). Antimicrobial use data were collected monthly from both public and private facilities. Each pilot site sought to document 30 patient encounters where antimicrobials were provided from 7 to 30 facilities per month. Antimicrobial use was expressed as the percentage of patients receiving a specific antimicrobial and as the number of defined daily doses of each specific antibiotic per 100 patients attending the facility per month. RESULTS: In all sites, there was extensive use of antimicrobials, with older agents being used more in the public sector and newer agents in the private sector. Although methodological differences limit the comparability of data, use appeared to be higher in India than in South Africa. Expressing antimicrobial use as the percentage of patients receiving a specific antimicrobial was more easily computed. Defined daily dose measure was useful in demonstrating differences in dosing and duration. CONCLUSION: All pilot sites provided data on antimicrobial use but also raised several issues related to methodology and logistics of long-term surveillance in community settings under resource constraints. Use measured as percentage of prescriptions is easier and more reliable in these settings.
Authors: Adhi Kristianto Sugianli; Franciscus Ginting; R Lia Kusumawati; Emmy Hermiyati Pranggono; Ayodhia Pitaloka Pasaribu; Firza Gronthoud; Suzanne Geerlings; Ida Parwati; Menno D De Jong; Frank Van Leth; Constance Schultsz Journal: J Antimicrob Chemother Date: 2017-05-01 Impact factor: 5.790
Authors: Heiman F L Wertheim; Nguyen Thi Kim Chuc; Sureeporn Punpuing; Wasif Ali Khan; Margaret Gyapong; Kwaku Poku Asante; Khatia Munguambe; F Xavier Gómez-Olivé; Proochista Ariana; Johannes John-Langba; Betuel Sigauque; Tran Khanh Toan; Stephen Tollman; Amelieke J H Cremers; Nga T T Do; Behzad Nadjm; H Rogier van Doorn; John Kinsman; Osman Sankoh Journal: Wellcome Open Res Date: 2017-07-28
Authors: Japheth A Opintan; Mercy J Newman; Reuben E Arhin; Eric S Donkor; Martha Gyansa-Lutterodt; William Mills-Pappoe Journal: Infect Drug Resist Date: 2015-11-18 Impact factor: 4.003