Availability, Prices and Affordability of Antibiotics Stocked by Informal Providers in Rural India: A Cross-Sectional Survey.
Availability, Prices and Affordability of Antibiotics Stocked by Informal Providers in Rural India: A Cross-Sectional Survey.
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DOI：
10.3390/antibiotics11040523
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发表时间：
2022-04-14
影响因子：
4.8
通讯作者：
Goodman, Catherine
中科院分区：
文献类型：
--
作者：
Gautham, Meenakshi;Miller, Rosalind;Rego, Sonia;Goodman, Catherine
关键词：
没有经过正规培训的供应商在印度农村地区提供医疗保健和抗生素，但对他们库存的抗生素知之甚少。我们对西孟加拉两个地区的非正规供应商（IP）进行了横断面调查，并评估了抗生素的可用性，以及它们的销售量，零售价格，IP的加价百分比和负担能力。在196个储备抗生素的IP中，85%储备片剂，74%储备糖浆/混悬剂/滴剂，18%储备注射剂。在所有IP中，库存了42种抗生素活性成分，其中包括来自74家制造商的278种品牌仿制药。库存量最大的五种活性成分是阿莫西林钾克拉维酸（占IP的52%）、头孢克肟（39%）、阿莫西林（33%）、阿奇霉素（25%）和环丙沙星（21%）。根据WHO的AWaRe分类，71%的IP储存了ACCESS抗生素，84%储存了WATCH抗生素。中位价与政府最高限价一致，但最低价与最高价品牌之间有很大差异。最便宜的前五种片剂是环丙沙星、阿奇霉素、头孢克肟和阿莫西林（每疗程0.8、0.9、1.9和1.9美元），最便宜的糖浆剂/混悬剂/滴剂是阿奇霉素和氧氟沙星（每疗程分别为1.7和4.5美元），这两种抗生素大多是WATCH抗生素。IP是农村社区医疗保健和抗生素的主要来源;针对IP的实际干预措施需要平衡限制WATCH抗生素和扩大负担得起的ACCESS抗生素篮子。
Providers without formal training deliver healthcare and antibiotics across rural India, but little is known about the antibiotics that they stock. We conducted a cross-sectional survey of such informal providers (IPs) in two districts of West Bengal, and assessed the availability of the antibiotics, as well as their sales volumes, retail prices, percentage markups for IPs and affordability. Of the 196 IPs that stocked antibiotics, 85% stocked tablets, 74% stocked syrups/suspensions/drops and 18% stocked injections. Across all the IPs, 42 antibiotic active ingredients were stocked, which comprised 278 branded generics from 74 manufacturers. The top five active ingredients that were stocked were amoxicillin potassium clavulanate (52% of the IPs), cefixime (39%), amoxicillin (33%), azithromycin (25%) and ciprofloxacin (21%). By the WHO’s AWaRe classification, 71% of the IPs stocked an ACCESS antibiotic and 84% stocked a WATCH antibiotic. The median prices were in line with the government ceiling prices, but with substantial variation between the lowest and highest priced brands. The most affordable among the top five tablets were ciprofloxacin, azithromycin, cefixime and amoxicillin (US$ 0.8, 0.9, 1.9 and 1.9 per course), and the most affordable among the syrups/suspensions/drops were azithromycin and ofloxacin (US$ 1.7 and 4.5 per course, respectively), which are mostly WATCH antibiotics. IPs are a key source of healthcare and antibiotics in rural communities; practical interventions that target IPs need to balance restricting WATCH antibiotics and expanding the basket of affordable ACCESS antibiotics.
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影响因子：
168.9
作者：
Holmes, Alison H.;Moore, Luke S. P.;Piddock, Laura J. V.
通讯作者：
Piddock, Laura J. V.
DOI：
10.1016/j.socscimed.2021.113813
发表时间：
2021-04
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Gautham M;Spicer N;Chatterjee S;Goodman C
通讯作者：
Goodman C
影响因子：
8.1
作者：
Dasari M;David SD;Miller E;Puyana JC;Roy N
通讯作者：
Roy N
影响因子：
4.8
作者：
Khare, Shweta;Purohit, Manju;Pathak, Ashish
通讯作者：
Pathak, Ashish
DOI：
10.1016/s2214-109x(21)00024-3
发表时间：
2021-05
期刊：
The Lancet. Global health
影响因子：
--
作者：
Do NTT;Vu HTL;Nguyen CTK;Punpuing S;Khan WA;Gyapong M;Asante KP;Munguambe K;Gómez-Olivé FX;John-Langba J;Tran TK;Sunpuwan M;Sevene E;Nguyen HH;Ho PD;Matin MA;Ahmed S;Karim MM;Cambaco O;Afari-Asiedu S;Boamah-Kaali E;Abdulai MA;Williams J;Asiamah S;Amankwah G;Agyekum MP;Wagner F;Ariana P;Sigauque B;Tollman S;van Doorn HR;Sankoh O;Kinsman J;Wertheim HFL
通讯作者：
Wertheim HFL