Objective: To investigate the feasibility of surveillance of antimicrobial use in the community in resource-constrained settings. Overuse and misuse of antimicrobial medicines is contributing to the development of resistance. The WHO Global Strategy for Containment of Antimicrobial Resistance recommends surveillance of use at all levels of the health sector but this is not done in most low and middle income countries.
Methods: Pilot projects were established in three sites in India (Delhi, Mumbai and Vellore) and 2 in South Africa (Brits and Durban). Antimicrobial use data were collected monthly from both public and private facilities. Each pilot site sought to document 30 patient encounters where antimicrobials were provided from 7 to 30 facilities per month. Antimicrobial use was expressed as the percentage of patients receiving a specific antimicrobial and as the number of defined daily doses of each specific antibiotic per 100 patients attending the facility per month.
Results: In all sites, there was extensive use of antimicrobials, with older agents being used more in the public sector and newer agents in the private sector. Although methodological differences limit the comparability of data, use appeared to be higher in India than in South Africa. Expressing antimicrobial use as the percentage of patients receiving a specific antimicrobial was more easily computed. Defined daily dose measure was useful in demonstrating differences in dosing and duration.
Conclusion: All pilot sites provided data on antimicrobial use but also raised several issues related to methodology and logistics of long-term surveillance in community settings under resource constraints. Use measured as percentage of prescriptions is easier and more reliable in these settings.
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http://dx.doi.org/10.1111/j.1365-3156.2010.02695.x | DOI Listing |
ACS Appl Mater Interfaces
January 2025
Oral & Maxillofacial Reconstruction and Regeneration of Luzhou Key Laboratory, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China.
Diabetic wound healing remains a major challenge in modern medicine. The persistent inflammation and immune dysfunction hinder angiogenesis by producing excessive ROS and increasing the susceptibility to bacterial infection. In this study, we developed an integrated strategy for whole-process management of diabetic wounds based on a bioinspired adhesive hydrogel platform with hemostasis, photothermal antimicrobial, antioxidant, anti-inflammatory, and angiogenic properties.
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January 2025
Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.
Cadmium is a non-essential element and neurotoxin that causes neuroinflammation, which leads to neurodegenerative diseases and brain cancer. To date, there are no specific or effective therapeutic agents to control inflammation and alleviate cadmium-induced progressive destruction of brain cells. Fluoroquinolones (FQs), widely used antimicrobials with effective blood-brain barrier penetration, show promise in being repurposed as anti-inflammatory drugs.
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January 2025
GuiZhou Institute of Subtropical Crops, Guizhou Academy of Agricultural Sciences, Guiyang, China.
Background: Fracture disrupts the integrity and continuity of the bone, leading to symptoms such as pain, tenderness, swelling, and bruising. Rhizoma Musae is a medicinal material frequently utilized in the Miao ethnic region of Guizhou Province, China. However, its specific mechanism of action in treating fractures remains unknown.
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January 2025
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
End-user feedback early in product development is important for optimizing multipurpose prevention technologies for HIV and pregnancy prevention. We evaluated the acceptability of the 90-day dapivirine levonorgestrel ring (DPV-LNG ring) used for 14 days compared to a dapivirine-only ring (DVR-200mg) in MTN-030/IPM 041 (n = 23), and when used for 90 days cyclically or continuously in MTN-044/IPM 053/CCN019 (n = 25). We enrolled healthy, non-pregnant, HIV-negative women aged 18-45 in Pittsburgh, PA and Birmingham, AL (MTN-030 only).
View Article and Find Full Text PDFPLoS One
January 2025
ICU, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong Province, China.
Introduction: Patients with cerebral hemorrhage often require a tracheal intubation to protect the airway and maintain oxygenation. Due to the use of analgesic and sedative drugs during endotracheal intubation and the opening of the glottis may easily cause aspiration pneumonia. Ceftriaxone is a semi-synthetic third-generation cephalosporin with strong antimicrobial activity against most gram-positive and gram-negative bacteria.
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