Frequent Community Use of Antibiotics among a Low-Economic Status Population in Manila, the Philippines: A Prospective Assessment Using a Urine Antibiotic Bioassay
| Autor: | Rontgene M. Solante, Paul S. Solano, Alexis Q. Dimapilis, Elizabeth O. Telan, Winston S. Go, Grace P. Retuerma, Koya Ariyoshi, Noriko Takamura, Arianne V. Lintag, Nobuo Saito, Christopher M. Parry, Maricel R. Ribo, Motoi Suzuki, Cherlyn D. Ubas, Carina H. Frayco |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Urban Population Medication history medicine.drug_class Philippines 030231 tropical medicine Population Antibiotics wa_395 Southeast asian Measles Rubella qw_45 Young Adult 03 medical and health sciences 0302 clinical medicine Interquartile range Virology Internal medicine Economic Status Humans Medicine Prospective Studies 030212 general & internal medicine Child education Poverty Aged education.field_of_study business.industry Infant Newborn Infant qv_350 Articles Odds ratio Middle Aged medicine.disease Drug Utilization Anti-Bacterial Agents Infectious Diseases Child Preschool Biological Assay Female Parasitology business |
| Zdroj: | The American journal of tropical medicine and hygiene |
| ISSN: | 0002-9637 |
| Popis: | The widespread unregulated use of antibiotics without medical consultation contributes to the burden of antibiotic resistance in Southeast Asian countries. This study investigated antibiotic use before hospital consultation. In a prospective observational study from February 2, 2015, to July 2, 2015, we enrolled febrile patients attending the emergency room in San Lazaro Hospital, Manila, the Philippines.Aurine sample was collected and a bioassay was used to detect antibiotic activity in urine using Bacillus stearothermophilus (ATCC7953), Escherichia coli (ATCC25922), and Streptococcus pyogenes (ATCC19615). Patients or caregivers reported their medication history, clinical information, and socioeconomic status. During the study period, 410 patients were enrolled. The median (interquartile range) age was 14 (7?23) years and 158 (39%) reported prior antibiotic use, predominantly a beta-lactam antibiotic. A total of 164 (40%,95% confidence interval [CI]: 35?45) patients were urine bioassay positive with any of three organisms. The Bacillus assay was the most sensitive, detecting 162 (99%, 95%CI: 96?100) cases. Among bioassay positive patients, dengue (N= 91, 55%,95% CI: 48?63) was the most frequent diagnosis, followed by other viral infections, including measles, rubella, and mumps (N= 17, 10%,95%CI: 6?16). Patients with a positive bioassay were significantly more likely to be from the lowestincome group (adjusted odds ratio [AOR]: 1.7; 95% CI: 1.1?2.6) and required hospital admission (AOR: 2.1; 95% CI: 1.3?3.5). Unnecessary antibiotic use for febrile illnesses before hospital consultation is common in a low-income, highly populated urban community in Manila. Education targeting this group should be implemented to reduce unnecessary antibiotic use. The American journal of tropical medicine and hygiene, 98(5), pp.1512-1519; 2018 |
| Databáze: | OpenAIRE |
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