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Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia

OBJECTIVES: Antimicrobial-resistant infections are a major global health issue. Ease of antimicrobial access in developing countries is proposed to be a key driver of the antimicrobial resistance (AMR) epidemic despite a lack of community antimicrobial usage data. METHODS: Using a mixed-methods appr...

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Autores principales: Thi Quynh Nhi, Le, de Alwis, Ruklanthi, Khanh Lam, Phung, Nhon Hoa, Nguyen, Minh Nhan, Nguyen, Thi Tu Oanh, Le, Thanh Nam, Dang, Nguyen Ngoc Han, Bui, Thi Thuy Huyen, Hoang, Thi Tuyen, Dinh, Thuy Duong, Vu, Lan Vi, Lu, Thi Thuy Tien, Bui, Thi Diem Tuyet, Hoang, Hoang Nha, Le, Thwaites, Guy E, Van Dung, Do, Baker, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105870/
https://www.ncbi.nlm.nih.gov/pubmed/29982636
http://dx.doi.org/10.1093/jac/dky231
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author Thi Quynh Nhi, Le
de Alwis, Ruklanthi
Khanh Lam, Phung
Nhon Hoa, Nguyen
Minh Nhan, Nguyen
Thi Tu Oanh, Le
Thanh Nam, Dang
Nguyen Ngoc Han, Bui
Thi Thuy Huyen, Hoang
Thi Tuyen, Dinh
Thuy Duong, Vu
Lan Vi, Lu
Thi Thuy Tien, Bui
Thi Diem Tuyet, Hoang
Hoang Nha, Le
Thwaites, Guy E
Van Dung, Do
Baker, Stephen
author_facet Thi Quynh Nhi, Le
de Alwis, Ruklanthi
Khanh Lam, Phung
Nhon Hoa, Nguyen
Minh Nhan, Nguyen
Thi Tu Oanh, Le
Thanh Nam, Dang
Nguyen Ngoc Han, Bui
Thi Thuy Huyen, Hoang
Thi Tuyen, Dinh
Thuy Duong, Vu
Lan Vi, Lu
Thi Thuy Tien, Bui
Thi Diem Tuyet, Hoang
Hoang Nha, Le
Thwaites, Guy E
Van Dung, Do
Baker, Stephen
author_sort Thi Quynh Nhi, Le
collection PubMed
description OBJECTIVES: Antimicrobial-resistant infections are a major global health issue. Ease of antimicrobial access in developing countries is proposed to be a key driver of the antimicrobial resistance (AMR) epidemic despite a lack of community antimicrobial usage data. METHODS: Using a mixed-methods approach (geospatial mapping, simulated clients, healthcare utilization, longitudinal cohort) we assessed antimicrobial access in the community and quantified antimicrobial usage for childhood diarrhoea in an urban Vietnamese setting. RESULTS: The study area had a pharmacy density of 15.7 pharmacies/km(2) (a pharmacy for every 1316 people). Using a simulated client method at pharmacies within the area, we found that 8% (3/37) and 22% (8/37) of outlets sold antimicrobials for paediatric watery and mucoid diarrhoea, respectively. However, despite ease of pharmacy access, the majority of caregivers would choose to take their child to a healthcare facility, with 81% (319/396) and 88% (347/396) of responders selecting a specialized hospital as one of their top three preferences when seeking treatment for watery and mucoid diarrhoea, respectively. We calculated that at least 19% (2688/14427) of diarrhoea episodes in those aged 1 to <5 years would receive an antimicrobial annually; however, antimicrobial usage was almost 10 times greater in hospitals than in the community. CONCLUSIONS: Our data question the impact of community antimicrobial usage on AMR and highlight the need for better education and guidelines for all professionals with the authority to prescribe antimicrobials.
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spelling pubmed-61058702018-08-27 Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia Thi Quynh Nhi, Le de Alwis, Ruklanthi Khanh Lam, Phung Nhon Hoa, Nguyen Minh Nhan, Nguyen Thi Tu Oanh, Le Thanh Nam, Dang Nguyen Ngoc Han, Bui Thi Thuy Huyen, Hoang Thi Tuyen, Dinh Thuy Duong, Vu Lan Vi, Lu Thi Thuy Tien, Bui Thi Diem Tuyet, Hoang Hoang Nha, Le Thwaites, Guy E Van Dung, Do Baker, Stephen J Antimicrob Chemother Original Research OBJECTIVES: Antimicrobial-resistant infections are a major global health issue. Ease of antimicrobial access in developing countries is proposed to be a key driver of the antimicrobial resistance (AMR) epidemic despite a lack of community antimicrobial usage data. METHODS: Using a mixed-methods approach (geospatial mapping, simulated clients, healthcare utilization, longitudinal cohort) we assessed antimicrobial access in the community and quantified antimicrobial usage for childhood diarrhoea in an urban Vietnamese setting. RESULTS: The study area had a pharmacy density of 15.7 pharmacies/km(2) (a pharmacy for every 1316 people). Using a simulated client method at pharmacies within the area, we found that 8% (3/37) and 22% (8/37) of outlets sold antimicrobials for paediatric watery and mucoid diarrhoea, respectively. However, despite ease of pharmacy access, the majority of caregivers would choose to take their child to a healthcare facility, with 81% (319/396) and 88% (347/396) of responders selecting a specialized hospital as one of their top three preferences when seeking treatment for watery and mucoid diarrhoea, respectively. We calculated that at least 19% (2688/14427) of diarrhoea episodes in those aged 1 to <5 years would receive an antimicrobial annually; however, antimicrobial usage was almost 10 times greater in hospitals than in the community. CONCLUSIONS: Our data question the impact of community antimicrobial usage on AMR and highlight the need for better education and guidelines for all professionals with the authority to prescribe antimicrobials. Oxford University Press 2018-09 2018-07-04 /pmc/articles/PMC6105870/ /pubmed/29982636 http://dx.doi.org/10.1093/jac/dky231 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Thi Quynh Nhi, Le
de Alwis, Ruklanthi
Khanh Lam, Phung
Nhon Hoa, Nguyen
Minh Nhan, Nguyen
Thi Tu Oanh, Le
Thanh Nam, Dang
Nguyen Ngoc Han, Bui
Thi Thuy Huyen, Hoang
Thi Tuyen, Dinh
Thuy Duong, Vu
Lan Vi, Lu
Thi Thuy Tien, Bui
Thi Diem Tuyet, Hoang
Hoang Nha, Le
Thwaites, Guy E
Van Dung, Do
Baker, Stephen
Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title_full Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title_fullStr Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title_full_unstemmed Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title_short Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia
title_sort quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in asia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105870/
https://www.ncbi.nlm.nih.gov/pubmed/29982636
http://dx.doi.org/10.1093/jac/dky231
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