Need to improve availability of “access” group antibiotics and reduce the use of “watch” group antibiotics in India for optimum use of antibiotics to contain antimicrobial resistance

Gandra, Sumanth; Kotwani, Anita

doi:10.1186/s40545-019-0182-1

Cited by 35 publications

(23 citation statements)

References 18 publications

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“…This high level of market offering of Watch antibiotics as opposed to the Access group has been observed also in India and Pakistan. 77 , 78 The target of the AWaRe categorization is 3-fold: achieve an increase in the use of Access antibiotics, the group associated with the lowest potential to induce AMR, to 60% by 2023; decrease the use of Watch antibiotics; and restrict Reserve antibiotics to infections caused by drug-resistant infections. 14 This target may be challenging in contexts with a large proportion of licensed antibiotic products being of the Watch category and with unrestricted access via over-the-counter sales of antibiotics, with implications for antimicrobial stewardship programs.…”

Section: Discussionmentioning

confidence: 99%

Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach

Orubu

Samad

Rahman

et al. 2021

Glob Health Sci Pract

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A standardized method for evaluating antimicrobial supply chains in the context of access and use could be a useful tool in assessing national capacity to implement programs that address antimicrobial resistance. We present both a novel ecological approach comprising mapping and the use of indicators that can be used to characterize national antimicrobial supply chains as well as benchmark countries and, for the first time, a country-level assessment of Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach

Orubu

Samad

Rahman

et al. 2021

Glob Health Sci Pract

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show abstract

“…The authors went on to state that although second- and third-generation cephalosporins offer several advantages, their use could be attributed to combination of factors such as changing prescribing practices, increasing antimicrobial resistance to other antibiotic classes and lack of availability of first-line penicillin antibiotics belonging to the Access group. 17 …”

Section: Discussionmentioning

confidence: 99%

Eight years of antibiotic consumption at a primary care outpatient facility in Trinidad and Tobago 2011–18: a synopsis of consumption trends

Khan

Gangar

et al. 2021

JAC-Antimicrobial Resistance

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Objectives To explore antibiotic consumption and surveillance patterns in Trinidad and Tobago. Methods A retrospective observational study was conducted. Stock requisition and logbooks from a District Health Facility in Trinidad were examined for the period 2011–18. Daily Defined Doses (DDDs) for each antibiotic were computed and extrapolated to represent the antibiotic consumption per 1000 residents within the population. Results The mean consumption across the years was 2.917 DDD per 1000 residents per day. The most consumed antibiotics were cefuroxime, amoxicillin/clavulanic acid, and azithromycin, with mean DDDs of 0.879, 0.695 and 0.373 respectively. The least consumed antibiotics were cefaclor and clarithromycin, with DDDs of 0.0006 and 0.0005, respectively. Conclusions Trinidad and Tobago is not mentioned in the WHO surveillance report on antibiotic consumption. Our most recent (2018) estimate of total antibiotic consumption was 3.224 DDD per 1000 habitants per day. This figure is an underestimate, as data was derived solely from the public sector. Notwithstanding, this data is novel and can provide a baseline for future comparison and development of national surveillance programmes.

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“…The increased use of broad-spectrum antibiotics could be attributed to their increased availability. The number of pharmaceutical companies manufacturing higher generation cephalosporins and amoxicillin + clavulanic acid was greater than the number of companies that manufacture amoxicillin [ 107 ]; in fact, only one company manufactured penicillin and benzathine penicillin [ 107 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Use and Misuse in Dentistry in India—A Systematic Review

et al. 2021

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Background: Infections caused by antibiotic resistance pose a serious global health threat, undermining our ability to treat common infections and deliver complex medical procedures. Antibiotic misuse, particularly in low-–middle-income countries, is accelerating this problem. Aim: The aim of this systematic review was to investigate the use and misuse of antibiotics in dentistry in India. Method: We included studies carried out on Indian populations evaluating the prescription of prophylactic or therapeutic antibiotics by dental practitioners or other healthcare providers, along with antibiotic self-medication by the general population. The primary outcome measure was prescription rate/use of antibiotics for dental/oral problems. The secondary outcome measures included indications for antibiotic use in dentistry, their types and regimens, factors influencing practitioners’ prescription patterns and any differences based on prescriber and patient characteristics. Multiple databases were searched with no restrictions on language or publication date. The quality assessment of all included studies was carried out using the AXIS tool for cross-sectional studies and the Joanna Briggs Institute checklist for qualitative studies. Results: Of the 1377 studies identified, 50 were eligible for review, comprising 35 questionnaire surveys, 14 prescription audits and one qualitative study (semi-structured interviews). The overall quality of the included studies was found to be low to moderate. The proportion of antibiotic prescriptions amongst all prescriptions made was found to range from 27% to 88%, with most studies reporting antibiotics in over half of all prescriptions; studies also reported a high proportion of prescriptions with a fixed dose drug combination. Worryingly, combination doses not recommended by the WHO AWaRe classification were being used. The rate of antibiotic self-medication reported for dental problems varied from 5% to 35%. Conclusions: Our review identified the significant misuse of antibiotics for dental diseases, with inappropriate use therapeutically and prophylactically, the use of broad spectrum and combination antibiotics not recommended by WHO, and self-medication by the general population. There is an urgent need for targeted stewardship programmes in this arena.

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Need to improve availability of “access” group antibiotics and reduce the use of “watch” group antibiotics in India for optimum use of antibiotics to contain antimicrobial resistance

Cited by 35 publications

References 18 publications

Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach

Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach

Eight years of antibiotic consumption at a primary care outpatient facility in Trinidad and Tobago 2011–18: a synopsis of consumption trends

Antibiotic Use and Misuse in Dentistry in India—A Systematic Review

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