Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales

Autor: M. Luisa Moura, James J. Lewis, Anna S. Levin, Icaro Boszczowski, Breno S. Kliemann
Jazyk: angličtina
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
Economics
lcsh:Medicine
Social Sciences
Academic Skills
Geographical locations
0302 clinical medicine
Antibiotics
Medicine and Health Sciences
Medicine
Psychology
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Functional illiteracy
education.field_of_study
Multidisciplinary
Antimicrobials
1. No poverty
Drugs
Socioeconomic Aspects of Health
3. Good health
Anti-Bacterial Agents
Infectious Diseases
Over-the-counter
Female
Brazil
Research Article
030106 microbiology
Population
Nonprescription Drugs
Microbiology
03 medical and health sciences
Population Metrics
Literacy
Environmental health
Microbial Control
Humans
Human Development Index
education
Socioeconomic status
Consumption (economics)
Pharmacology
Population Density
Pharmacies
Population Biology
business.industry
lcsh:R
Cognitive Psychology
Biology and Life Sciences
South America
Private sector
Legislation
Drug
Economic Analysis
Drug Utilization
Health Care
Socioeconomic Factors
Antibiotic Resistance
Life expectancy
Cognitive Science
lcsh:Q
Antimicrobial Resistance
People and places
business
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 12, p e0167885 (2016)
ISSN: 1932-6203
Popis: BACKGROUND: Improper antibiotic use is one of the main drivers of bacterial resistance to antibiotics, increasing infectious diseases morbidity and mortality and raising costs of healthcare. The level of antibiotic consumption has been shown to vary according to socioeconomic determinants (SED) such as income and access to education. In many Latin American countries, antibiotics could be easily purchased without a medical prescription in private pharmacies before enforcement of restrictions on over-the-counter (OTC) sales in recent years. Brazil issued a law abolishing OTC sales in October 2010. This study seeks to find SED of antibiotic consumption in the Brazilian state of São Paulo (SSP) and to estimate the impact of the 2010 law. METHODS: Data on all oral antibiotic sales having occurred in the private sector in SSP from 2008 to 2012 were pooled into the 645 municipalities of SSP. Linear regression was performed to estimate consumption levels that would have occurred in 2011 and 2012 if no law regulating OTC sales had been issued in 2010. These values were compared to actual observed levels, estimating the effect of this law. Linear regression was performed to find association of antibiotic consumption levels and of a greater effect of the law with municipality level data on SED obtained from a nationwide census. RESULTS: Oral antibiotic consumption in SSP rose from 8.44 defined daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010, and fell to 8.06 DID in 2012. Determinants of a higher consumption were higher human development index, percentage of urban population, density of private health establishments, life expectancy and percentage of females; lower illiteracy levels and lower percentage of population between 5 and 15 years old. A higher percentage of females was associated with a stronger effect of the law. CONCLUSIONS: SSP had similar antibiotic consumption levels as the whole country of Brazil, and they were effectively reduced by the policy.
Databáze: OpenAIRE
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