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The judicious use of antibiotics—An investment towards optimized health care

  • New Drugs Antibiotics
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Abstract

During the past century the excitement of discovering antibiotics as a treatment of infectious diseases has given way to a sense of complacency and acceptance that when faced with antimicrobial resistance there will always be new and better antimicrobial agents to use. Now, with clear indications of a decline in pharmaceutical company interest in anti-infective research, at the same time when multi-drug resistant micro-organisms continue to be reported, it is very important to review the prudent use of the available agents to fight these micro-organisms. Injudicious use of antibiotics is a global problem with some countries more affected than others. There is no dearth of interest in this subject with scores of scholarly articles written about it. While over the counter access to antibiotics is mentioned as an important contributor towards injudicious antibiotic use in developing nations, as shown in a number of studies, there are many provider, practice and patient characteristics which drive antibiotic overuse in developed nations such as the United States. Recognizing that a thorough review of this subject goes far and beyond the page limitations of a review article we provide a summary of some of the salient aspects of this global problem with a focus towards readers practicing in developing nations.

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References

  1. Palumbi SR. Humans as the world's greatest evolutionary force.Science 2001; 1786–1790.

  2. Spellberg B, Powers JH, Brass EP, Miller LG, Edwards JE, Jr. Trends in antimicrobial drug development: implications for the future.Clin Infect Dis 2004; 1279–1286.

  3. Shea KM. Antibiotic resistance: what is the impact of agricultural uses of antibiotics on children's health?Pediatrics 2003; 253–258.

  4. Seppala H, Klaukka T, Vuopio-Varkila J, Muotiala A, Helenius H, Lager K, Huovinen P. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance.N Engl J Med 1997; 441–446.

  5. Gilliver MA, Benentt M, Begon M, Hazel SM, Hart CA. Antibiotic resistance found in wild rodents.Nature 1999; 233–4.

  6. Osterblad M, Norrdahl K, Korpimaki E, Huovinen P. Antibiotic resistance. How wild are wild mammals?Nature 2001; 37–38.

  7. Enne VI, Livermore DM, Stephens P, Hall LM. Persistence of sulphonaide resistance in Escherichia coli in the UK despite national prescribing restriction.Lancet 2001; 1325–1328.

  8. Phillips I. Prudent use of antibiotics: are our expectations justified?Clin Infect Dis 2001; S130–S132.

  9. Chiew YF, Yeo SF, Hall LM, Livermore DM. Can susceptibility to an antimicrobial be restored by halting its use? The case of streptomycin versus Enterobacteriacea.J Antimicrob Chemother 1998; 247–251.

  10. Heuer OE, Pedersen K, Andersen JS, Madsen M. Vancomycin-resistant enterococci (VRE) in broiler flocks 5 years after the avoparcin ban.Microb Drug Resist 2002; 133–138.

  11. Lieu TA, Fleisher GR, Schwartz JS. Cost-effectiveness of rapid latex agglutination testing and throat culture for streptococcal pharyngitis.Pediatrics 1990; 246–256.

  12. French GL. Clinical impact and relevance of antibiotic resistance.Adv Drug Deliv Rev 2005; 1514–1527.

  13. Gonzales R, Malone DC, Maselli JH, Sande MA. Excessive antibiotic use for acute respiratory infections in the United States.Clin Infect Dis 2001; 757–762.

  14. Shea KM. Nontherapeutic use of antimicrobial agents in animal agriculture: implications for pediatrics.Pediatrics, 2004; 862–868.

  15. Gaur AH, Hare ME, Shorr RI. Provider and practice characteristics associated with antibiotic use in children with presumed viral respiratory tract infections.Pediatrics 2005; 635–641.

  16. nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis.JAMA 1998; 875–877.

  17. Mainous AG, III, Hueston WJ, Love MM. Antibiotics for colds in children: who are the high prescribers?Arch Pediatr Adolesc Med 1998; 349–352.

  18. Steinke DT, Bain DJ, MacDonald TM, Davey PG. Practice factors that influence antibiotic prescribing in general practice

  19. Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats.BMJ 1998; 637–642.

  20. Hare ME, Gaur AH, Arnold S, Somes GW, Shorr RI. “Does it Really Take Longer ‘Not to Prescribe’ Antibiotics for Viral URI in Children?”. 2003 Pediatric Academic Societies’ Annual Meeting 2003.

  21. Hui L, Li XS, Zeng XJ, Dai YH, Foy HM. Patterns and determinants of use of antibiotics for acute respiratory tract infection in children in China.Pediatr Infect Dis J 1997; 560–564.

  22. Bosu WK, Ofori-Adjei D. Survey of antibiotic prescribing pattern in government health facilities of the Wassa west district of Ghana.East Afr Med J 1997; 138‐142.

  23. Fidler DP. Legal issues associated with antimicrobial drug resistance.Emerg Infect Dis 1998; 169–177.

  24. Gumodoka B, Vos J, Berege ZA, van Aste HA, Dolmans WM, Borgdorff MW. Injection practices in Mwanza Region, Tanzania: prescriptions, patient demand and sterility.Trop Med Int Health 1996; 874–880.

  25. Barden LS, Dowell SF, Schwartz B, Lackey C. Current attitudes regarding use of antimicrobial agents: results from physician's and parents' focus group discussions.Clin Pediatr (Phila) 1998; 665–671.

  26. Norrby SR. Antibiotic resistance: a self-inflicted problem.J Intern Med 1996; 373–375.

  27. Mainous AG, III, Zoorob RJ, Oler MJ, Haynes DM. Patient knowledge of upper respiratory infections: implications for antibiotic expectations and unnecessary utilization.J Fam Pract 1997; 75–83.

  28. Vinson DC, Lutz LJ. The effect of parental expectations on treatment of children with a cough: a report from ASPN.J Fam Pract 1993; 23–27.

  29. Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH. The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior.Pediatrics 1999; 711–718.

  30. Bauchner H, Pelton SI, Klein JO. Parents, physicians, and antibiotic use.Pediatrics 1999; 395–401.

  31. Belongia EA, Sullivan BJ, Chyou PH, Madagame E, Reed KD, Schwartz B. A community intervention trial to promote judicious antibiotic use and reduce penicillin-resistant Streptococcus pneumoniae carriage in children.Pediatrics 2001; 575–583.

  32. Kuzujanakis, M, Kleinman K, Rifas-Shiman S, Finkelstein JA. Correlates of parental antibiotic knowledge, demand, and reported use.Ambul Pediatr 2003; 203–210.

  33. Macfarlane J, Holmes W, Macfarlane R, Britten N. Influence of patients' expectations on antibiotic management of acute lower respiratory tract illness in general practice: questionnaire study.BMJ 1997; 1211–1214.

  34. Branthwaite A, Pechere JC. Pan-European survey of patients' attitudes to antibiotics and antibiotic use.J Int Med Res, 1996; 229–238.

  35. Haak H. Pharmaceuticals in two Brazilian villages: lay practices and perceptions.Soc Sci Med 1988; 1415–1427.

  36. Guillemot D, Carbon C, Balkau B, Geslin P, Lecoeur H, Vauzelle-Kervroedan F, Bouvenot G, Eschwege E. Low dosage and long treatment duration of beta-lactam: risk factors for carriage of penicillin-resistant Streptococcus pneumoniae.JAMA 1998; 365–370.

  37. Kunin CM, Lipton HL, Tupasi T, Sacks T, Scheckler WE, Jivani A, Goic A, Martin RR, Guerrant RL, Thamlikitkul V. Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4.Rev Infect Dis 1987;S270–S285.

  38. Nichter M, Vuckovic N. Agenda for an anthropology of pharmaceutical practice.Soc Sci Med 1994; 1509–1525.

  39. Shapiro MF. Regulating pharmaceutical advertising: what will work?CMAJ 1997; 359–361.

  40. Finkelstein JA, Davis RL, Dowell SF, Metlay JP, Soumerai SB, Rifas-Shiman SL, Higham M, Miller Z, Miroshnik I, Pedan A, Platt R. Reducing antibiotic use in children: a randomized trial in 12 practices.Pediatrics 2001; 1–7.

  41. Macfarlane J, Holmes W, Gard P, Thornhill D, Macfarlane R, Hubbard R. Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet.BMJ 2002; 91–4.

  42. Christakis DA, Zimmerman FJ, Wright JA, Garrison MM, Rivara FP, Davis RL. A randomized controlled trial of point-of-care evidence to improve the antibiotic prescribing practices for otitis media in children.Pediatrics 2001; E15.

  43. Thomson O'Brien MA, Freemantle N, Oxman AD, Wolf F, Davis DA, Herrin J. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane.Database Syst Rev 2001; CD003030.

  44. Thomson O'Brien MA, Oxman AD, Davis DA, Haynes RB, Freemantle N, Harvey EL. Education outreach visits: effects on professional practice and health care outcomes. Cochrane. Database.Syst Rev 2000; CD000409.

  45. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies.JAMA 1995; 700–705.

  46. Avorn J, Soumerai SB. Improving drug-therapy decisions through educational outreach. A randomized controlled trial of academically based “detailing”.N Engl J Med 1983; 1457–1463.

  47. Thomson O'Brien MA, Oxman AD, Haynes RB, Davis DA, Freemantle N, Harvey EL. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane.Database Syst Rev 2000; CD000125.

  48. Mandell LA, Bartlett JG, Dowell SF, File TM, Jr., Musher DM, Whitney C. Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults.Clin Infect Dis 2003; 1405–1433.

  49. Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections.Pediatrics 1998; 163–165.

  50. Weekes LM, Brooks C. Drug and Therapeutics Committees in Australia: expected and actual performance.Br J Clin Pharmacol 1996; 551–557.

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Authors and Affiliations

  1. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA

    Aditya H. Gaur & B. Keith English

  2. Department of Infectious Diseases, St. Jude Children's Research Hospital, 332 N. Lauderdale Street, 38105-2794, Memphis, TN, USA

    Aditya H. Gaur

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  1. Aditya H. Gaur
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  2. B. Keith English
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Correspondence to Aditya H. Gaur.

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Gaur, A.H., English, B.K. The judicious use of antibiotics—An investment towards optimized health care. Indian J Pediatr 73, 343–350 (2006). https://doi.org/10.1007/BF02825829

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