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Teaching Appropriate Antibiotic Use in Developing Countries

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Abstract

The use of antimicrobial drugs has saved countless lives and reduced the morbidity of infectious diseases. However, the growing threat from resistant microorganisms calls for cost-effective interventions to prevent the emergence of new resistant strains and the spread of existing ones. One approach to reduce the incidence of infections due to antibiotic-resistant organisms is to control the inappropriate use of antibiotics in both the hospital and community settings. In order to achieve this goal, it is necessary to identify the factors involved in physician’s antibiotic prescription patterns and to elaborate educational interventions that can be adapted to different clinical scenarios. Several studies in developed countries have shown the potential benefit of these interventions. However, developing countries pose a special situation as they lack adequate pharmacological surveillance systems, antimicrobial drugs are widely available to the public (even without prescription), and continuous medical education programs for physicians are non-existent. The implementation of educational programs directed to the judicious use of antimicrobial drugs might probe to be the most efficient intervention in developing countries in the worldwide battle against antimicrobial resistance.

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References

  • American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics 2004;113:1451–65.

    Article  Google Scholar 

  • Apisarnthanarak A, Danchaivijitr S, Khawcharoenporn T, et al. Effectiveness of education and an antibiotic-control program in a tertiary care hospital in Thailand. Clin Infect Dis 2006;42:768–75

    Article  PubMed  Google Scholar 

  • Avorn J, Solomon DH. Cultural and economic factors that (mis)shape antibiotic use: the nonpharmacologic basis of therapeutics. Ann Intern Med 2000;133:128–35.

    CAS  PubMed  Google Scholar 

  • Barden LS, Dowell SF, Schwartz B, Lackey C. Current attitudes regarding use of antimicrobial agents: results from physician's and parents' focus group discussions. Clin Pediatr (Phila) 1998;37:665–71.

    Article  CAS  Google Scholar 

  • Barza M, Gorbach S, DeVincent SJ. Introduction. Clin Infect Dis 2002;34 Suppl 3:S71–2.

    Article  PubMed  Google Scholar 

  • Bauchner H, Pelton SI, Klein JO. Parents, physicians, and antibiotic use. Pediatrics 1999;103:395–401.

    Article  CAS  PubMed  Google Scholar 

  • Bexell A, Lwando E, von Hofsten B, Tembo S, Eriksson B, Diwan VK. Improving drug use through continuing education: a randomized controlled trial in Zambia. J Clin Epidemiol 1996;49:355–7

    Article  CAS  PubMed  Google Scholar 

  • Bojalil R, Calva JJ. Antibiotic misuse in diarrhea. A household survey in a Mexican community. J Clin Epidemiol 1994;47:147–56

    Article  CAS  PubMed  Google Scholar 

  • Calva J, Bojalil R. Antibiotic use in a periurban community in Mexico: a household and drugstore survey. Soc Sci Med 1996;42:1121–8

    Article  CAS  PubMed  Google Scholar 

  • CDC Centers for Disease Control and Prevention Practice Tips. Accessed at http://www.cdc.gov/drugresistance/community/files/ads/Practpac.pdf

  • Colgan R, Powers JH. Appropriate antimicrobial prescribing: approaches that limit antibiotic resistance. Am Fam Physician 2001;64:999–1004

    CAS  PubMed  Google Scholar 

  • Dollman WB, LeBlanc VT, Stevens L, O'Connor PJ, Turnidge JD. A community-based intervention to reduce antibiotic use for upper respiratory tract infections in regional South Australia. Med J Aust 2005;182:617–20.

    PubMed  Google Scholar 

  • Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics 1998;101:163–5.

    Google Scholar 

  • Emmer CL, Besser RE. Combating antimicrobial resistance: intervention programs to promote appropriate antibiotic use. Infect Med 2002;19:160–73.

    Google Scholar 

  • Fakih MG, Hilu RC, Savoy-Moore RT, Saravolatz LD. Do resident physicians use antibiotics appropriately in treating upper respiratory infections? A survey of 11 programs. Clin Infect Dis 2003;37:853–6.

    Article  PubMed  Google Scholar 

  • Fleming A. 1945. Penicillin. Nobel Lecture. Accessed at http://nobelprize.org/medicine/laureates/1945/fleming-lecture.pdf

  • Froom J, Culpepper L, Grob P, et al. Diagnosis and antibiotic treatment of acute otitis media: report from International Primary Care Network. BMJ 1990;300:582–6.

    Article  CAS  PubMed  Google Scholar 

  • Gamboa-Salcedo T, Gutierrez-Camacho C, Mota-Hernandez F. Manejo de la diarrea en el hogar: errores y aciertos. Gac Med Mex 2006;142:309–14

    PubMed  Google Scholar 

  • Gonzales R, Sande MA. Uncomplicated acute bronchitis. Ann Intern Med 2000;133:981–91.

    CAS  PubMed  Google Scholar 

  • Gouws E, Bryce J, Habicht JP, et al. Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy. Bull World Health Organ 2004;82:509–15.

    PubMed  Google Scholar 

  • Gutierrez G, Guiscafre H, Bronfman M, Walsh J, Martinez H, Munoz O. Changing physician prescribing patterns: evaluation of an educational strategy for acute diarrhea in Mexico City. Med Care 1994;32:436–46.

    Article  CAS  PubMed  Google Scholar 

  • Hennessy TW, Petersen KM, Bruden D, et al. Changes in antibiotic-prescribing practices and carriage of penicillin-resistant Streptococcus pneumoniae: a controlled intervention trial in rural Alaska. Clin Infect Dis 2002;34:1543–50.

    Article  PubMed  Google Scholar 

  • Hutchinson JM, Foley RN. Method of physician remuneration and rates of antibiotic prescription. CMAJ 1999;160:1013–7.

    CAS  PubMed  Google Scholar 

  • Ibia E, Sheridan M, Schwartz R. Knowledge of the principles of judicious antibiotic use for upper respiratory infections: a survey of senior medical students. South Med J 2005;98:889–95.

    Article  PubMed  Google Scholar 

  • Ibia EO, Schwartz RH, Freij BJ, Sheridan MJ. Judicious antibiotic use for purulent rhinorrhea: do pediatric infectious disease specialists practice what they preach? Clin Pediatr (Phila) 2003;42:443–6.

    Article  Google Scholar 

  • Keiser J, Utzinger J, Tanner M, Singer BH. Representation of authors and editors from countries with different human development indexes in the leading literature on tropical medicine: survey of current evidence. BMJ 2004;328:1229–32

    Article  PubMed  Google Scholar 

  • Kozyrskyj AL, Carrie AG, Mazowita GB, Lix LM, Klassen TP, Law BJ. Decrease in antibiotic use among children in the 1990s: not all antibiotics, not all children. CMAJ 2004;171:133–8.

    PubMed  Google Scholar 

  • Linder JA, Huang ES, Steinman MA, Gonzales R, Stafford RS. Fluoroquinolone prescribing in the United States: 1995 to 2002. Am J Med 2005;118:259–68.

    Article  PubMed  Google Scholar 

  • Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics 1999;103:711–8.

    Article  CAS  PubMed  Google Scholar 

  • McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescription in ambulatory care settings, United States, 1992–2000. Emerg Infect Dis 2003;9:432–7.

    PubMed  Google Scholar 

  • Mora Y, Avila-Aguero ML, Umana MA, Jimenez AL, Paris MM, Faingezicht I. Epidemiological observations of the judicious use of antibiotics in a pediatric teaching hospital. Int J Infect Dis 2002;6:74–7.

    Article  PubMed  Google Scholar 

  • Nambiar S, Schwartz RH, Sheridan MJ. Antibiotic use for upper respiratory tract infections: how well do pediatric residents do? Arch Pediatr Adolesc Med 2002;156:621–4.

    PubMed  Google Scholar 

  • National Center for Health Statistics-National Hospital Ambulatory Medical Care Survey. Accessed at http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm

  • Niederman MS. Impact of antibiotic resistance on clinical outcomes and the cost of care. Crit Care Med 2001;29:N114–20.

    Article  CAS  PubMed  Google Scholar 

  • Nizami SQ, Khan IA, Bhutta ZA. Drug prescribing practices of general practitioners and paediatricians for childhood diarrhoea in Karachi, Pakistan. Soc Sci Med 1996;42:1133–9.

    Article  CAS  PubMed  Google Scholar 

  • Okeke IN, Lamikanra A, Edelman R. Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries. Emerg Infect Dis 1999;5:18–27

    Article  CAS  PubMed  Google Scholar 

  • Ong S, Nakase J, Moran GJ, Karras DJ, Kuehnert MJ, Talan DA. Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction. Ann Emerg Med 2007;50:213–20.

    Article  PubMed  Google Scholar 

  • Perez-Cuevas R, Guiscafre H, Munoz O, et al. Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico. Soc Sci Med 1996;42:1185–94.

    Article  CAS  PubMed  Google Scholar 

  • Pineda M, Romano L, Pacheco A, Pavia N, Santos JI, Alpuche CM. 2007. Encuesta sobre conocimientos básicos de antibióticos y su uso clínico en residentes del Hospital Infantil de México Federico Gómez. UNAM. Mexico

    Google Scholar 

  • Powers JH. Diagnosis and treatment of acute otitis media: evaluating the evidence. Infect Dis Clin North Am 2007;21:409–26, vi.

    Article  PubMed  Google Scholar 

  • Rubin MA, Bateman K, Alder S, Donnelly S, Stoddard GJ, Samore MH. A multifaceted intervention to improve antimicrobial prescribing for upper respiratory tract infections in a small rural community. Clin Infect Dis 2005;40:546–53.

    Article  PubMed  Google Scholar 

  • Santoso B, Suryawati S, Prawaitasari JE. Small group intervention vs formal seminar for improving appropriate drug use. Soc Sci Med 1996;42:1163–8.

    Article  CAS  PubMed  Google Scholar 

  • Scott JG, Cohen D, DiCicco-Bloom B, Orzano AJ, Jaen CR, Crabtree BF. Antibiotic use in acute respiratory infections and the ways patients pressure physicians for a prescription. J Fam Pract 2001;50:853–8.

    CAS  PubMed  Google Scholar 

  • Spellberg B, Powers JH, Brass EP, Miller LG, Edwards JE, Jr. Trends in antimicrobial drug development: implications for the future. Clin Infect Dis 2004;38:1279–86.

    Article  CAS  PubMed  Google Scholar 

  • Vernacchio L, Vezina RM, Mitchell AA. Management of acute otitis media by primary care physicians: trends since the release of the 2004 American Academy of Pediatrics/American Academy of Family Physicians clinical practice guideline. Pediatrics 2007;120:281–7.

    Article  PubMed  Google Scholar 

  • Weissman J, Besser RE. Promoting appropriate antibiotic use for pediatric patients: a social ecological framework. Semin Pediatr Infect Dis 2004;15:41–51.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Celia M. Alpuche Aranda .

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Alpuche Aranda, C.M., Mazzotti, L.R. (2010). Teaching Appropriate Antibiotic Use in Developing Countries. In: Sosa, A., Byarugaba, D., Amábile-Cuevas, C., Hsueh, PR., Kariuki, S., Okeke, I. (eds) Antimicrobial Resistance in Developing Countries. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89370-9_28

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