Saito, Nobuo, Takamura, Noriko, Retuerma, Grace P, Frayco, Carina H, Solano, Paul S, Ubas, Cherlyn D, Lintag, Arianne V, Ribo, Maricel R, Solante, Rontgene M, Dimapilis, Alexis Q et al (show 5 more authors)
(2018)
Frequent Community Use of Antibiotics among a Low-Economic Status Population in Manila, the Philippines: A Prospective Assessment Using a Urine Antibiotic Bioassay.
The American journal of tropical medicine and hygiene, 98 (5).
pp. 1512-1519.
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Abstract
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. A urine sample was collected and a bioassay was used to detect antibiotic activity in urine using <i>Bacillus stearothermophilus</i> (ATCC7953), <i>Escherichia coli</i> (ATCC25922), and <i>Streptococcus pyogenes</i> (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 <i>Bacillus</i> assay was the most sensitive, detecting 162 (99%, 95% CI: 96-100) cases. Among bioassay positive patients, dengue (<i>N</i> = 91, 55%, 95% CI: 48-63) was the most frequent diagnosis, followed by other viral infections, including measles, rubella, and mumps (<i>N</i> = 17, 10%, 95% CI: 6-16). Patients with a positive bioassay were significantly more likely to be from the lowest-income 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.
Item Type: | Article |
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Uncontrolled Keywords: | Humans, Anti-Bacterial Agents, Biological Assay, Prospective Studies, Poverty, Adolescent, Adult, Aged, Middle Aged, Child, Child, Preschool, Infant, Infant, Newborn, Urban Population, Drug Utilization, Philippines, Female, Male, Young Adult, Economic Status |
Depositing User: | Symplectic Admin |
Date Deposited: | 21 Oct 2019 07:30 |
Last Modified: | 19 Jan 2023 00:22 |
DOI: | 10.4269/ajtmh.17-0564 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3058835 |