Sujith J Chandy|Kurien Thomas|E Mathai|B. Antonisamy|Kathleen Holloway|Cecilia Stålsby Lundborg
Patterns of antibiotic use in the community and challenges of antibiotic surveillance in a lower-middle-income country setting: a repeated cross-sectional study in Vellore, south India
Karolinska Institutet|Christian Medical College & Hospital|Christian Medical College|World Health Organization|Christian Medical College & Hospital|World Health Organization Regional Office for South-East Asia|Karolinska Institutet
considerable evidence linking antibiotic usage bacterial resistance intervention strategies needed contain antibiotic use thereby resistance plan appropriate strategies imperative undertake surveillance community monitor antibiotic encounters drivers specific antibiotic misuse surveillance rarely place lowermiddleincome countries lmics study describes antibiotic patterns challenges faced developing surveillance systems lmicsurveillance antibiotic encounters prescriptions dispensations carried using repeated crosssectional design 2 years vellore south india every month patients attending 30 health facilities small hospitals general practitioner clinics pharmacy shops observed 30 antibiotic encounters attained antibiotic use expressed percentage encounters containing specific antibiotics defined daily doses ddds100 patients bulk antibiotic sales data also collectedover 2 years total 52788 patients observed 21600 antibiotic encounters 409 accrued fluoroquinolones penicillins widely used rural hospitals used cotrimoxazole often urban private hospitals used cephalosporins often 411 antibiotic prescriptions respiratory infections main challenges surveillance included issues regarding sampling data collection denominator calculation sustainabilitypatterns antibiotic use varied across health facilities suggesting interventions involve types health facilities although challenges encountered study shows possible develop surveillance systems lmics data generated may used plan feasible interventions assess impact thereby contain resistance