Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India
Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India
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DOI：
10.3390/antibiotics8030139
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发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Pathak, Ashish
中科院分区：
文献类型：
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作者：
Khare, Shweta;Purohit, Manju;Pathak, Ashish
非正规医疗服务提供者（IHCP）是印度农村地区主要的医疗服务提供者，他们在没有经过正规培训的情况下开处方。IHCP的抗生素处方可以为控制抗生素耐药性提供重要信息。本研究的目的是确定IHCP对常见疾病抗生素处方的实践和季节变化。在印度Ujjain的农村人口监测点进行了一项为期18个月的重复横断面研究，涵盖了不同季节。收集了12名IHCP给门诊患者的处方。总共分析了323种不同投诉组合的15，322份处方，其中11，336份（74%）包括抗生素。结果显示，14，620（95%）的抗生素处方是广谱的，最常见的处方是氟喹诺酮类（4771，31%），其次是青霉素和广谱（4119，27%）和第三代头孢菌素（3069，20%）。在口腔和牙齿问题（1126，88%）、发热（3569，87%）和上呼吸道感染（3273，81%）中，抗生素的使用频率更高;在季风季节（2350，76%）使用频率更高;儿童（3340，81%）比成人（7996，71%）使用频率更高。该研究得出结论，与其他常见疾病药物相比，抗生素是更常见的处方药，其中大多数是广谱抗生素，这种情况需要进一步调查，然后立即协调努力，以减少IHCP不必要的抗生素处方。
Informal healthcare providers (IHCPs) are predominant healthcare providers in rural India, who prescribe without formal training. Antibiotic prescription by IHCPs could provide crucial information for controlling antibiotic resistance. The aim of this study is to determine the practices and seasonal changes in antibiotic prescribing for common illnesses by IHCPs. A repeated cross-sectional study was conducted over 18 months, covering different seasons in the rural demographic surveillance site, at Ujjain, India. Prescriptions given to outpatients by 12 IHCPs were collected. In total, 15,322 prescriptions for 323 different complaint combinations were analyzed, of which 11,336 (74%) included antibiotics. The results showed that 14,620 (95%) of antibiotics prescribed were broad spectrum and the most commonly prescribed were fluoroquinolones (4771,31%), followed by penicillin with an extended spectrum (4119,27%) and third-generation cephalosporin (3069,20%). Antibiotics were prescribed more frequently in oral and dental problems (1126,88%), fever (3569,87%), and upper respiratory tract infections (3273, 81%); more during the monsoon season (2350,76%); and more frequently to children (3340,81%) than to adults (7996,71%). The study concludes that antibiotics were the more commonly prescribed drugs compared to other medications for common illnesses, most of which are broad-spectrum antibiotics, a situation that warrants further investigations followed by immediate and coordinated efforts to reduce unnecessary antibiotic prescriptions by IHCPs.