Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data

Boeckel, Thomas P. Van; Gandra, Sumanth; Ashok, Ashvin; Caudron, Quentin; Grenfell, Bryan T.; Levin, Simon A.; Laxminarayan, Ramanan

doi:10.1016/s1473-3099(14)70780-7

Cited by 1,909 publications

(1,359 citation statements)

References 41 publications

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“…Also, increased incidental antibiotic use could possibly explain why H. pylori seropositivity levels in the US and in Puerto Rico are comparable and lower than seropositivity levels reported in other Latin American countries. In a study reporting worldwide antibiotic usage, individuals in the US were found to use more antibiotics than Latin American countries 31, 32…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

et al. 2017

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Background Helicobacter pylori is an important etiologic factor for peptic ulcers and gastric cancer, one of the top ten leading causes of cancer death in Puerto Rico. However, the prevalence of H. pylori infections in this population was previously unknown. The aim of this study was to examine the seroprevalence of H. pylori and its associated risk factors in Puerto Rico.Materials and MethodsA cross‐sectional study was designed using an existing population‐based biorepository. Seropositivity was determined using the Premier™ H. pylori immunoassay. Helicobacter pylori seroprevalence was estimated with 95% confidence using marginal standardization following logistic regression. To assess the risk factors associated with H. pylori seropositivity, a multivariable log‐binomial model was fitted to estimate the prevalence ratio (PR) and its 95% confidence interval (95% CI).ResultsA total of 528 population‐based serum samples were analyzed. The mean age of the study population was 41 ± 12 years, of whom 55.3% were females. The overall seroprevalence of H. pylori was 33.0% (95% CI = 28.3%‐38.1%). Increasing age and having <12 years of education were significantly (P < .05) associated with H. pylori seropositivity in the multivariable model; however, residing in counties with low population density reached marginal significance (P = .085).ConclusionsWe report that H. pylori infection is common among Hispanics living in Puerto Rico. The H. pylori seroprevalence observed in Puerto Rico is similar to the seroprevalence reported in the overall population of the United States. The association between H. pylori seroprevalence and the risk factors analyzed offers insight into the epidemiology of gastric cancer in Puerto Rico and warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

et al. 2017

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“…Indeed, it is in the hospital and health care units, where antibiotherapy is intensively used, that the most dramatic selective conditions to ARB are expected (WHO 2014). For this reason, it is arguable that hospital effluents may represent an important environmental reservoir of antibiotic resistance.…”

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

“…Unfortunately, the same improvement was not extensive to sanitation, and therefore, the risks of contamination of drinking water may be, at least in some world regions, in-creased (GEMS-Water 2014; UNICEF/WHO 2015). Drinking water can be either abstracted from microbiologically safe water resources or disinfected prior its use, aiming at reducing pathogens to levels below the hazardous limit (WHO 2014). Therefore, it is expected that in drinking water, both the diversity of bacterial species and the possible occurrence of antibiotic resistance will have different characteristics of what can be found in wastewater.…”

Section: Drinking Watermentioning

confidence: 99%

“…For this rea-son, it is arguable that the selective pressures found in animal production environments are important drivers for antibiotic resistance dissemination (Cabello et al 2013;Done et al 2015;Xiong et al 2015). Although the same active principles can be used in human medicine and in animal production, the pattern of utilization is different (Cabello et al 2013;WHO 2014;EFSA/ECDC 2015;Done et al 2015). While human medicine, mainly in what concerns antibiotics administration in health care units, tends to use last-generation antibiotics of classes of fluoroquinolones, cephalosporins, or carbapenems, in animal production, "older" antibiotics such as tetracyclines, sulfonamides, or penicillins are preferred (WHO 2014; EFSA/ECDC 2015; Done et al 2015).…”

Section: Other Antibiotic Resistance Reservoirs Associated With the Umentioning

confidence: 99%

“…A major driver for the dissemination of antibiotic resistance is supposed to be the use of antibiotics, which, between the years of 2000 and 2010, increased in 36 %, with major contributions from Brazil, Russia, India, China, and South Africa (Van Boeckel et al 2014). An impor-tant fraction of these antibiotics is discharged in sewage, together with bacteria of human and animal origin (Michael et al 2013;Rizzo et al 2013b).…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic resistance in urban aquatic environments: can it be controlled?

Manaia

Macedo

Fatta‐Kassinos

et al. 2015

Appl Microbiol Biotechnol

184

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Over the last decade, numerous evidences have contributed to establish a link between the natural and human-impacted environments and the growing public health threat that is the antimicrobial resistance. In the environment, in particular in areas subjected to strong anthropogenic pressures, water plays a major role on the transformation and transport of contaminants including antibiotic residues, antibiotic-resistant bacteria, and antibiotic resistance genes. Therefore, the urban water cycle, comprising water abstraction, disinfection, and distribution for human consumption, and the collection, treatment, and delivery of wastewater to the environment, is a particularly interesting loop to track the fate of antibiotic resistance in the environment and to assess the risks of its trans-mission back to humans. In this article, the relevance of different transepts of the urban water cycle on the potential enrichment and spread of antibiotic resistance is reviewed. According to this analysis, some gaps of knowledge, research needs, and control measures are suggested. The critical rationale behind the measures suggested and the desirable involvement of some key action players is also discussed.

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Prescription Strategies in Acute Uncomplicated Respiratory Infections

Abad¹,

Dalmau

Bakedano³

et al. 2016

JAMA Intern Med

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; for the Delayed Antibiotic Prescription (DAP) Group IMPORTANCE Delayed antibiotic prescription helps to reduce antibiotic use with reasonable symptom control. There are different strategies of delayed prescription, but it is not yet clear which one is the most effective. OBJECTIVE To determine the efficacy and safety of 2 delayed strategies in acute, uncomplicated respiratory infections. DESIGN, SETTING, AND PARTICIPANTS We recruited 405 adults with acute, uncomplicated respiratory infections from 23 primary care centers in Spain to participate in a pragmatic, open-label, randomized clinical trial. INTERVENTIONS Patients were randomized to 1 of 4 potential prescription strategies: (1) a delayed patient-led prescription strategy; (2) a delayed prescription collection strategy requiring patients to collect their prescription from the primary care center; (3) an immediate prescription strategy; or (4) a no antibiotic strategy. Delayed prescription strategies consist of prescribing an antibiotic to take only if the symptoms worsen or if there is no improvement several days after the medical visit. MAIN OUTCOMES AND MEASURES The primary outcomes were the duration of symptoms and severity of symptoms. Each symptom was scored using a 6-point Likert scale (scores of 3 or 4 were considered moderate; 5 or 6, severe). Secondary outcomes included antibiotic use, patient satisfaction, and patients' beliefs in the effectiveness of antibiotics. RESULTS A total of 405 patients were recruited, 398 of whom were included in the analysis; 136 patients (34.2%) were men; mean (SD) age, 45 (17) years. The mean severity of symptoms ranged from 1.8 to 3.5 points on the Likert scale, and mean (SD) duration of symptoms described on first visit was 6 (6) days. The mean (SD) general health status on first visit was 54 (20) based on a scale with 0 indicating worst health status; 100, best status. Overall, 314 patients (80.1%) were nonsmokers, and 372 patients (93.5%) did not have a respiratory comorbidity. The presence of symptoms on first visit was similar among the 4 groups. The mean (SD) duration of severe symptoms was 3.6 (3.3) days for the immediate prescription group and 4.7 (3.6) days for the no prescription group. The median (interquartile range [IQR]) of severe symptoms was 3 (1-4) days for the prescription collection group and 3 (2-6) days for the patient-led prescription group. The median (IQR) of the maximum severity for any symptom was 5 (3-5) for the immediate prescription group and the prescription collection group; 5 (4-5) for the patient-led prescription group; and 5 (4-6) for the no prescription group. Patients randomized to the no prescription strategy or to either of the delayed strategies used fewer antibiotics and less frequently believed in antibiotic effectiveness. Satisfaction was similar across groups. CONCLUSIONS AND RELEVANCE Delayed strategies were associated with slightly greater but clinically similar symptom burden and duration and also with substantially reduced antibiotic use when compared with an immediate...

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Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data

Cited by 1,909 publications

References 41 publications

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

Antibiotic resistance in urban aquatic environments: can it be controlled?

Prescription Strategies in Acute Uncomplicated Respiratory Infections

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