Growth in the use of antibiotics in the community in England and Scotland in 1980-93

Davey, Peter; Bax, Richard; Newey, Janice; Reeves, D. S.; Rutherford, Daniel; Slack, R. C. B.; Warren, Rachel; Watt, B; Wilson, John

doi:10.1136/bmj.312.7031.613

Cited by 65 publications

(31 citation statements)

References 2 publications

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“…A recent report on the use of antibiotics in Dutch hospitals certainly supports this view (112). The use of tetracyclines for community medicine is declining in many countries, with reduced prescription rates recently recorded for tetracyclines in Spain (23), the United States (172), and the United Kingdom (54). In the United Kingdom this followed an earlier period of decline between 1967 and 1984 (44).…”

Section: Quantities Of Tetracyclines Used Introductionmentioning

confidence: 82%

Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance

Chopra

Roberts

2001

Microbiol Mol Biol Rev

3,644

2,643

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Tetracyclines were discovered in the 1940s and exhibited activity against a wide range of microorganisms including gram-positive and gram-negative bacteria, chlamydiae, mycoplasmas, rickettsiae, and protozoan parasites. They are inexpensive antibiotics, which have been used extensively in the prophlylaxis and therapy of human and animal infections and also at subtherapeutic levels in animal feed as growth promoters. The first tetracycline-resistant bacterium, Shigella dysenteriae, was isolated in 1953. Tetracycline resistance now occurs in an increasing number of pathogenic, opportunistic, and commensal bacteria. The presence of tetracycline-resistant pathogens limits the use of these agents in treatment of disease. Tetracycline resistance is often due to the acquisition of new genes, which code for energy-dependent efflux of tetracyclines or for a protein that protects bacterial ribosomes from the action of tetracyclines. Many of these genes are associated with mobile plasmids or transposons and can be distinguished from each other using molecular methods including DNA-DNA hybridization with oligonucleotide probes and DNA sequencing. A limited number of bacteria acquire resistance by mutations, which alter the permeability of the outer membrane porins and/or lipopolysaccharides in the outer membrane, change the regulation of innate efflux systems, or alter the 16S rRNA. New tetracycline derivatives are being examined, although their role in treatment is not clear. Changing the use of tetracyclines in human and animal health as well as in food production is needed if we are to continue to use this class of broad-spectrum antimicrobials through the present century

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Section: Quantities Of Tetracyclines Used Introductionmentioning

confidence: 82%

Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance

Chopra

Roberts

2001

Microbiol Mol Biol Rev

3,644

2,643

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“…The 4 most frequently asked questions focused on associated upper or lower respiratory tract infections, presence of nasal discharge, Presence of nasal discharge 15 (30) 7 (14) .09…”

Section: Resultsmentioning

confidence: 99%

Pathways for Inappropriate Dispensing of Antibiotics for Rhinosinusitis: A Randomized Trial

Contopoulos‐Ioannidis

Koliofoti

Koutroumpa

et al. 2001

CLIN INFECT DIS

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We evaluated the extent of and factors that determine the inappropriate use of antibiotics that are obtained without a physician's prescription. Ninety-eight Greek pharmacists were visited by actress-researchers who played clients requesting antibiotics without a physician's prescription. Pharmacists were randomly challenged in a scenario that involved simulated cases of acute uncomplicated rhinosinusitis with either low fever (38.5 degrees C) or high fever (40 degrees C). Antibiotics were offered by 34 (69%) of 49 pharmacists who were presented with the high-fever scenario and by 42 (86%) of 49 pharmacists who were presented with the low-fever scenario (risk difference, 16.3%; P = .05). Thirty-two (65%) and 35 (71%) pharmacists in the high- and low-fever study arms, respectively, agreed to sell the actress-researchers broad-spectrum antibiotics. Only 28 (57%) and 17 (35%) pharmacists, respectively, recommended that the patient visit a physician (P = .03). Inappropriate recommendations regarding antibiotic use were very common in the studied setting. Antibiotics were more likely to be offered to persons who did not have a prescription when they were less likely to be clinically indicated.

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“…Do mesmo modo, tem sido apontada na literatura a adoção, na atenção primária, de opções terapêuticas inadequadas, privilegiando fármacos de segunda linha ou reservados ao uso hospitalar 7 . No que se refere aos erros de dosagem e duração de tratamento, Vergeles-Blanca et al 2 observaram, no meio hospitalar, que a posologia inadequada foi responsá-vel pela maioria dos erros de prescrição dos antimicrobianos.…”

Section: Introductionunclassified

Avaliação da qualidade das prescrições de antimicrobianos dispensadas em unidades públicas de saúde de Belo Horizonte, Minas Gerais, Brasil, 2002

et al. 2007

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Overuse of antibiotics is a public health problem and has raised discussions concerning their rational use. This cross-sectional study focuses on the use of systemic antibiotics under the IntroduçãoOs antibacterianos constituem um grupo de medicamentos amplamente prescritos em atenção primária, ocupando sempre um dos primeiros lugares entre as classes de medicamentos mais utilizadas 1,2 . O seu uso desnecessário e abusivo, tanto na comunidade quanto no meio hospitalar, tem sido extensivamente descrito na literatura 1,2,3,4 .O uso maciço e inadequado de antibacterianos tem implicações no aumento das taxas de resistência microbiana, existindo uma relação direta entre o quantitativo de antimicrobianos usados e a incidência de resistência bacteriana 4 .À parte as conseqüências médicas e ecoló-gicas, existe ainda um custo social e pessoal do uso inadequado desses medicamentos, que envolve custos diretos de tratamentos, internações, dias não trabalhados, faltas escolares, invalidez e morte. Tais implicações justificam esforços empreendidos no sentido de conhecer e racionalizar a utilização de antimicrobianos.Dentre as diversas estratégias na área da utilização e monitorização do uso de medicamentos, destacam-se os estudos de hábitos de prescrição médica. Os prescritores exercem um importante papel na promoção do uso racional de medicamentos, de modo que a análise de seus hábitos de prescrição proporciona o conhecimento de aspectos da qualidade da terapia. Conseqüente-mente, permite identificar problemas, implantar ARTIGO ARTICLE Abrantes PM et al. 96 Cad. Saúde Pública, Rio de Janeiro, 23(1):

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Growth in the use of antibiotics in the community in England and Scotland in 1980-93

Cited by 65 publications

References 2 publications

Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance

Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance

Pathways for Inappropriate Dispensing of Antibiotics for Rhinosinusitis: A Randomized Trial

Avaliação da qualidade das prescrições de antimicrobianos dispensadas em unidades públicas de saúde de Belo Horizonte, Minas Gerais, Brasil, 2002

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