A survey of antimicrobial prescribing and dispensing practices in rural Bangladesh

Mamun, Kazi Zulfiquer; Tabassum, Shahina; Shears, P.; Hart, C. A.

doi:10.3329/mmj.v15i1.9

Cited by 18 publications

(22 citation statements)

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“…The results of the current study reflect the presence of NDM-1 producers in Bangladesh. Inappropriate and non-prescription antibiotic use might be the probable cause of development of high antimicrobial resistance in this subcontinent [22]. In addition, with NDM-1 producers, the current study found 13 (37.15%) VIM-1, 23 (65.71%) VIM-2, 18 (51.43%) IMP-1 and 9 (25.71%) IMP-2 producers among the imipenemresistant bacteria.…”

Section: Discussionsupporting

confidence: 47%

Isolation and molecular characterization of New Delhi metallo-beta-lactamase-1 producing superbug in Bangladesh

Farzana

Shamsuzzaman

Mamun

2013

J Infect Dev Ctries

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Introduction: New Delhi metallo-beta-lactamse-1 (NDM-1) producing superbugs create a global public health problem because of their resistance to most antibiotics. This study was conducted to determine the presence of MBL producers, including NDM-1 producers, in Bangladesh, along with the antimicrobial resistance patterns of these organisms. Methodology: Thirty-five isolates resistant to imipenem by disk diffusion technique were investigated for MBL production. Minimum inhibitory concentration (MIC) of imipenem was determined by agar dilution method. MBL producers were phenotypically detected by double disk synergy test and combined disk assay. Gene encoding blaIMP-1, blaIMP-2, blaVIM-1, blaVIM-2, blaNDM-1 and class 1 integron was identified by PCR. Results: Thirty-one (88.57%) MBL producers were detected by PCR, 24 (68.57%) by double disk synergy test, and 30 (85.71%) by combined disk assay. Eight (22.86%) were positive for blaNDM-1, 13 (37.15%) for blaVIM-1, 21 (60.00%) for blaVIM-2, 18 (51.43%) for blaIMP-1, and 9 (25.71%) for blaIMP-2. More than one blaMBL was present in 23 (65.71%) of the isolates. MIC of imipenem of MBL producers ranged from ≥256 µg/ml to ≤8 µg/ml. All the NDM-1 producing isolates carried class 1 integron. NDM-1 producers were 100% resistant to amoxicillin, cephradine, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, aztreonam, gentamicin and piperacillin, 87.5% to amikacin, 75% to ciprofloxacin, and 62.5% to co-trimoxazole and the combination of tazobactam and piperacillin. All were sensitive to colistin. Conclusion: The results of this study provide insight into the presence of blaMBL, including blaNDM-1, in Bangladesh. Urgent epidemiological monitoring of MBL producers in Bangladesh may combat their rapid dissemination.

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Section: Discussionsupporting

confidence: 47%

Isolation and molecular characterization of New Delhi metallo-beta-lactamase-1 producing superbug in Bangladesh

Farzana

Shamsuzzaman

Mamun

2013

J Infect Dev Ctries

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“…It was high as compared to the study conducted in Nepal and Turkey but lower than that of India [30][31][32]. In Bangladesh, all the antibiotics were prescribed on the basis of patient's complaints and also the antibiotics were used in inappropriate doses and durations particularly among the children under-five [33,34]. High proportions of prescriptions of antibiotic by the physicians might be appeared to be a lack of confidence or misuse of microbiological laboratory services and absence of policies on antimicrobial use and above all poor consulting period.…”

Section: Discussionmentioning

confidence: 91%

Patterns of Prescription and Antibiotic Use Among Outpatients in a Tertiary Care Teaching Hospital of Bangladesh

Datta

Paul

Monwar

et al. 2016

Int J Pharm Pharm Sci

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Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to World Health Organisation (WHO).Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%). Conclusion:Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients.

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“…Sullivan et al 13 , Macfarlane et al 14 and Ngeow et al 4 observed Mycoplasma pneumoniae 9.3%, 2.4% and 9.2% respectively in their study. Falguera 17 observed Chlamydia pneumoniae 11.0%, Mycoplasma pneumoniae 9.0%.…”

Section: Discussionmentioning

confidence: 98%

Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

Salam¹,

Amin

Islam³

2017

J. Bangladesh Coll. Phys.

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Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134

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A survey of antimicrobial prescribing and dispensing practices in rural Bangladesh

Cited by 18 publications

References 0 publications

Isolation and molecular characterization of New Delhi metallo-beta-lactamase-1 producing superbug in Bangladesh

Isolation and molecular characterization of New Delhi metallo-beta-lactamase-1 producing superbug in Bangladesh

Patterns of Prescription and Antibiotic Use Among Outpatients in a Tertiary Care Teaching Hospital of Bangladesh

Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

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