Antibiotic consumption patterns and drug leftovers in 6000 Brazilian households

Abstract

Worldwide data indicate that antibiotics are frequently used indiscriminately. The present study used a questionnaire in an attempt to quantify and qualify outpatient antibiotic consumption habits, including when the drug was used, who recommended it, and to what extent treatment was completed, and to question householders on the presence of antibiotics in their homes, including leftovers from previous treatments. The questionnaire was distributed to residents of 6000 households that made up a representative sample of the Brazilian population and was completed by designated respondents from 4932 residences (82.2%) with or without field interviewer supervision. Each household reported an average of 3.7 treatments in the previous year, with amoxicillin the most frequently used antibiotic in this survey (18%), regardless of socioeconomic class. Most treatments were recommended through medical prescription, and this source of antibiotic was associated with the highest rate of completed therapy (80.4%). Azithromycin and ciprofloxacin produced the highest rates of completed treatment and the lowest rates of antibiotic leftovers. Storing antibiotics at home increases the cost of each treatment event, reduces efficacy, and may encourage the emergence of resistant organisms in the community. Educational efforts must be redoubled to promote the rational and effective use of drugs, especially antibiotics.

A global survey of antibiotic leftovers in the outpatient setting

“…50% of respondents studied. Indeed, possession of leftover antibiotics and their use have been reported previously in a number of developed and developing countries [2,[8][9][10][11][12][13][14]. A survey performed previously revealed the percentage of respondents who saved antibiotics and used them on future occasions ranged from 4% in the UK to 41% in Italy [15].…”

A systematic review and meta-analysis of misuse of antibiotic therapies in the community

“…Of the seven compliance estimates using inperson questionnaires, six estimates [24,48,58] defined compliance as finishing the antibiotic course, and three studies [4,23,25,47]. Five of the six studies that used selfadministered questionnaires to assess compliance defined it as completing the antibiotic course [27,31,40,44,57], whilst one study did not state its definition of compliance [46]. Pill counts were used to assess compliance in 10 estimates.…”

“…The study populations were geographically diverse, with only one study conducted in the United States [54] and one-half conducted in developing nations [4,18,46,49,50], including Thailand, Ethiopia and Brazil. All studies used subjective measures to assess compliance, including self-administered questionnaires [27,46,54], telephone interviews [4,47,50] and in-person interviews [18,49,58]. Assessment of leftover antibiotic use involved recall of an antibiotic prescription in the past or over a defined period of time, and actual leftover definitions varied slightly across studies.…”

“…Assessment of leftover antibiotic use involved recall of an antibiotic prescription in the past or over a defined period of time, and actual leftover definitions varied slightly across studies. Definitions identified in the review included saving medication for future use [18,49,50], ever taking antibiotics without a physician's prescription [54], having leftovers [46,47,58,61], and sharing or saving antibiotics [27].…”

Influence of the amoxicillin concentration on organics removal and microbial community structure in an anaerobic EGSB reactor treating with antibiotic wastewater

“…In b-lactam group, AMX is one of the most widely used antibiotic drugs [7], which is widespread in the aquatic environment including wastewater as reported. And it has been reported that AMX concentration in the raw antibiotic wastewater reach to 171 mg L À1 [8].…”