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Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR

INTRODUCTION: Antibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated...

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Autores principales: Machowska, Anna, Sihavong, Amphoy, Eriksen, Jaran, Vongsouvath, Manivanh, Marrone, Gaetano, Sychareun, Vanphanom, Hanson, Claudia, Keohavong, Bounxou, Brauner, Annelie, Mayxay, Mayfong, Kounnavong, Sengchanh, Lundborg, Cecilia Stalsby
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678367/
https://www.ncbi.nlm.nih.gov/pubmed/33427692
http://dx.doi.org/10.1136/bmjopen-2020-040334
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author Machowska, Anna
Sihavong, Amphoy
Eriksen, Jaran
Vongsouvath, Manivanh
Marrone, Gaetano
Sychareun, Vanphanom
Hanson, Claudia
Keohavong, Bounxou
Brauner, Annelie
Mayxay, Mayfong
Kounnavong, Sengchanh
Lundborg, Cecilia Stalsby
author_facet Machowska, Anna
Sihavong, Amphoy
Eriksen, Jaran
Vongsouvath, Manivanh
Marrone, Gaetano
Sychareun, Vanphanom
Hanson, Claudia
Keohavong, Bounxou
Brauner, Annelie
Mayxay, Mayfong
Kounnavong, Sengchanh
Lundborg, Cecilia Stalsby
author_sort Machowska, Anna
collection PubMed
description INTRODUCTION: Antibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated vaginal deliveries is widespread in many parts of the world. Similarly, irrational use of antibiotics is reported for children. There is scarcity of evidence regarding antibiotic use and ABR in Lao PDR (Laos). The overarching aim of this project is to fill those knowledge gaps and to evaluate a quality improvement intervention. The primary objective is to estimate the proportion of uncomplicated vaginal deliveries where antibiotics are used and to compare its trend before and after the intervention. METHODS AND ANALYSIS: This 3-year, prospective, quasiexperimental study without comparison group includes a formative and interventional phase. Data on antibiotic use during delivery will be collected from medical records. Knowledge, attitudes and reported practices on antibiotic use in pregnancy, during delivery and for children, will be collected from women through questionnaires. Healthcare providers’ knowledge, attitudes and practices of antibiotics administration for pregnant women, during delivery and for children, will be collected via adapted questionnaires. Perceptions regarding antibiotics will be explored through focus group discussions with women and individual interviews with key stakeholders. Faecal samples for culturing of Escherichia coli and Klebsiella spp. and antibiotic susceptibility testing will be taken before, during and 6 months after delivery to determine colonisation of resistant strains. The planned intervention will comprise training workshops, educational materials and social media campaign and will be evaluated using interrupted time series analysis. ETHICS AND DISSEMINATION: The project received ethical approval from the National Ethics Committee for Health Research, Ministry of Health, Laos. The results will be disseminated via scientific publications, conference presentations and communication with stakeholders. TRAIL REGISTRATION NUMBER: ISRCTN16217522; Pre-results.
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spelling pubmed-76783672020-11-30 Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR Machowska, Anna Sihavong, Amphoy Eriksen, Jaran Vongsouvath, Manivanh Marrone, Gaetano Sychareun, Vanphanom Hanson, Claudia Keohavong, Bounxou Brauner, Annelie Mayxay, Mayfong Kounnavong, Sengchanh Lundborg, Cecilia Stalsby BMJ Open Global Health INTRODUCTION: Antibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated vaginal deliveries is widespread in many parts of the world. Similarly, irrational use of antibiotics is reported for children. There is scarcity of evidence regarding antibiotic use and ABR in Lao PDR (Laos). The overarching aim of this project is to fill those knowledge gaps and to evaluate a quality improvement intervention. The primary objective is to estimate the proportion of uncomplicated vaginal deliveries where antibiotics are used and to compare its trend before and after the intervention. METHODS AND ANALYSIS: This 3-year, prospective, quasiexperimental study without comparison group includes a formative and interventional phase. Data on antibiotic use during delivery will be collected from medical records. Knowledge, attitudes and reported practices on antibiotic use in pregnancy, during delivery and for children, will be collected from women through questionnaires. Healthcare providers’ knowledge, attitudes and practices of antibiotics administration for pregnant women, during delivery and for children, will be collected via adapted questionnaires. Perceptions regarding antibiotics will be explored through focus group discussions with women and individual interviews with key stakeholders. Faecal samples for culturing of Escherichia coli and Klebsiella spp. and antibiotic susceptibility testing will be taken before, during and 6 months after delivery to determine colonisation of resistant strains. The planned intervention will comprise training workshops, educational materials and social media campaign and will be evaluated using interrupted time series analysis. ETHICS AND DISSEMINATION: The project received ethical approval from the National Ethics Committee for Health Research, Ministry of Health, Laos. The results will be disseminated via scientific publications, conference presentations and communication with stakeholders. TRAIL REGISTRATION NUMBER: ISRCTN16217522; Pre-results. BMJ Publishing Group 2020-11-19 /pmc/articles/PMC7678367/ /pubmed/33427692 http://dx.doi.org/10.1136/bmjopen-2020-040334 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Global Health
Machowska, Anna
Sihavong, Amphoy
Eriksen, Jaran
Vongsouvath, Manivanh
Marrone, Gaetano
Sychareun, Vanphanom
Hanson, Claudia
Keohavong, Bounxou
Brauner, Annelie
Mayxay, Mayfong
Kounnavong, Sengchanh
Lundborg, Cecilia Stalsby
Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title_full Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title_fullStr Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title_full_unstemmed Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title_short Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
title_sort containment of antibiotic resistance—measures to improve antibiotic use in pregnancy, childbirth and young children (carechild): a protocol of a prospective, quasiexperimental interventional study in lao pdr
topic Global Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678367/
https://www.ncbi.nlm.nih.gov/pubmed/33427692
http://dx.doi.org/10.1136/bmjopen-2020-040334
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