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Trends in antibiotic use among outpatients in New Delhi, India.
BMC Infect Dis. 2011 Apr 20; 11:99.BI

Abstract

BACKGROUND

The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. There is much ad-hoc information about the inappropriate consumption of antibiotics, over-the-counter availability, and inadequate dosage but there is very little actual evidence of community practices.

METHODS

This study surveyed antibiotic use in the community (December 2007-November 2008) using the established methodology of patient exit interviews at three types of facilities: 20 private retail pharmacies, 10 public sector facilities, and 20 private clinics to obtain a complete picture of community antibiotic use over a year. The Anatomical Therapeutic Chemical (ATC) classification and the Defined Daily Dose (DDD) measurement units were assigned to the data. Antibiotic use was measured as DDD/1000 patients visiting the facility and also as percent of patients receiving an antibiotic.

RESULTS

During the data collection period, 17995, 9205, and 5922 patients visiting private retail pharmacies, public facilities and private clinics, respectively, were included in our study. 39% of the patients attending private retail pharmacies and public facilities and 43% of patients visiting private clinics were prescribed at least one antibiotic. Consumption patterns of antibiotics were similar at private retail pharmacies and private clinics where fluoroquinolones, cephalosporins, and extended spectrum penicillins were the three most commonly prescribed groups of antibiotics. At public facilities, there was a more even use of all the major antibiotic groups including penicillins, fluoroquinolones, macrolides, cephalosporins, tetracyclines, and cotrimoxazole. Newer members from each class of antibiotics were prescribed. Not much seasonal variation was seen although slightly higher consumption of some antibiotics in winter and slightly higher consumption of fluoroquinolones during the rainy season were observed.

CONCLUSIONS

A very high consumption of antibiotics was observed in both public and private sector outpatients. There was a high use of broad spectrum and newer antibiotics in the community. Suitable and sustainable interventions should be implemented to promote rational use of antibiotics that will help in decreasing the menace of antibiotic resistance.

Authors+Show Affiliations

Department of Pharmacology, V P Chest Institute, University of Delhi, Delhi, India. anitakotwani@gmail.comNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21507212

Citation

Kotwani, Anita, and Kathleen Holloway. "Trends in Antibiotic Use Among Outpatients in New Delhi, India." BMC Infectious Diseases, vol. 11, 2011, p. 99.
Kotwani A, Holloway K. Trends in antibiotic use among outpatients in New Delhi, India. BMC Infect Dis. 2011;11:99.
Kotwani, A., & Holloway, K. (2011). Trends in antibiotic use among outpatients in New Delhi, India. BMC Infectious Diseases, 11, 99. https://doi.org/10.1186/1471-2334-11-99
Kotwani A, Holloway K. Trends in Antibiotic Use Among Outpatients in New Delhi, India. BMC Infect Dis. 2011 Apr 20;11:99. PubMed PMID: 21507212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in antibiotic use among outpatients in New Delhi, India. AU - Kotwani,Anita, AU - Holloway,Kathleen, Y1 - 2011/04/20/ PY - 2010/11/30/received PY - 2011/04/20/accepted PY - 2011/4/22/entrez PY - 2011/4/22/pubmed PY - 2011/9/29/medline SP - 99 EP - 99 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 11 N2 - BACKGROUND: The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. There is much ad-hoc information about the inappropriate consumption of antibiotics, over-the-counter availability, and inadequate dosage but there is very little actual evidence of community practices. METHODS: This study surveyed antibiotic use in the community (December 2007-November 2008) using the established methodology of patient exit interviews at three types of facilities: 20 private retail pharmacies, 10 public sector facilities, and 20 private clinics to obtain a complete picture of community antibiotic use over a year. The Anatomical Therapeutic Chemical (ATC) classification and the Defined Daily Dose (DDD) measurement units were assigned to the data. Antibiotic use was measured as DDD/1000 patients visiting the facility and also as percent of patients receiving an antibiotic. RESULTS: During the data collection period, 17995, 9205, and 5922 patients visiting private retail pharmacies, public facilities and private clinics, respectively, were included in our study. 39% of the patients attending private retail pharmacies and public facilities and 43% of patients visiting private clinics were prescribed at least one antibiotic. Consumption patterns of antibiotics were similar at private retail pharmacies and private clinics where fluoroquinolones, cephalosporins, and extended spectrum penicillins were the three most commonly prescribed groups of antibiotics. At public facilities, there was a more even use of all the major antibiotic groups including penicillins, fluoroquinolones, macrolides, cephalosporins, tetracyclines, and cotrimoxazole. Newer members from each class of antibiotics were prescribed. Not much seasonal variation was seen although slightly higher consumption of some antibiotics in winter and slightly higher consumption of fluoroquinolones during the rainy season were observed. CONCLUSIONS: A very high consumption of antibiotics was observed in both public and private sector outpatients. There was a high use of broad spectrum and newer antibiotics in the community. Suitable and sustainable interventions should be implemented to promote rational use of antibiotics that will help in decreasing the menace of antibiotic resistance. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/21507212/Trends_in_antibiotic_use_among_outpatients_in_New_Delhi_India_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-99 DB - PRIME DP - Unbound Medicine ER -