We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Quantifying antimicrobial access and usage for paediatric diarrhoeal disease in an urban community setting in Asia.
- Authors
Nhi, Le Thi Quynh; Alwis, Ruklanthi de; Lam, Phung Khanh; Hoa, Nguyen Nhon; Nhan, Nguyen Minh; Oanh, Le Thi Tu; Nam, Dang Thanh; Han, Bui Nguyen Ngoc; Huyen, Hoang Thi Thuy; Tuyen, Dinh Thi; 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
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>The study area had a pharmacy density of 15.7 pharmacies/km2 (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.<bold>Conclusions: </bold>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.
- Subjects
VIETNAM; DIARRHEA; ANTI-infective agents; WORLD Health Organization; COMMUNICABLE diseases; PUBLIC health; ANTIBIOTICS; DRUG utilization statistics; COMPARATIVE studies; HEALTH services accessibility; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; EVALUATION research
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2018, Vol 73, Issue 9, p2546
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dky231