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Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India
Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy HSP Med Focusing A, Tomtebodavagen 18A, SE-17177 Stockholm, Sweden;RD Gardi Med Coll, Dept Publ Hlth & Environm, Ujjain 456006, Madhya Pradesh, India.ORCID iD: 0000-0001-5879-7815
Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy HSP Med Focusing A, Tomtebodavagen 18A, SE-17177 Stockholm, Sweden;RD Gardi Med Coll, Dept Pathol, Ujjain 456006, Madhya Pradesh, India.
Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy HSP Med Focusing A, Tomtebodavagen 18A, SE-17177 Stockholm, Sweden;RD Gardi Med Coll, Dept Pharmacol, Ujjain 456006, Madhya Pradesh, India.
Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy HSP Med Focusing A, Tomtebodavagen 18A, SE-17177 Stockholm, Sweden;RD Gardi Med Coll, Indian Initiat Management Antibiot Resistance, Dept Environm Med, Ujjain 456006, Madhya Pradesh, India.
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2019 (English)In: Antibiotics, ISSN 0066-4774, E-ISSN 2079-6382, Vol. 8, no 3, article id 139Article in journal (Refereed) Published
Abstract [en]

Informal healthcare providers (IHCPs) are predominant healthcare providers in rural India, who prescribe without formal training. Antibiotic prescription by IHCPs could provide crucial information for controlling antibiotic resistance. The aim of this study is to determine the practices and seasonal changes in antibiotic prescribing for common illnesses by IHCPs. A repeated cross-sectional study was conducted over 18 months, covering different seasons in the rural demographic surveillance site, at Ujjain, India. Prescriptions given to outpatients by 12 IHCPs were collected. In total, 15,322 prescriptions for 323 different complaint combinations were analyzed, of which 11,336 (74%) included antibiotics. The results showed that 14,620 (95%) of antibiotics prescribed were broad spectrum and the most commonly prescribed were fluoroquinolones (4771,31%), followed by penicillin with an extended spectrum (4119,27%) and third-generation cephalosporin (3069,20%). Antibiotics were prescribed more frequently in oral and dental problems (1126,88%), fever (3569,87%), and upper respiratory tract infections (3273, 81%); more during the monsoon season (2350,76%); and more frequently to children (3340,81%) than to adults (7996,71%). The study concludes that antibiotics were the more commonly prescribed drugs compared to other medications for common illnesses, most of which are broad-spectrum antibiotics, a situation that warrants further investigations followed by immediate and coordinated efforts to reduce unnecessary antibiotic prescriptions by IHCPs.

Place, publisher, year, edition, pages
MDPI , 2019. Vol. 8, no 3, article id 139
Keywords [en]
Healthcare providers, prescription, antibiotics, infectious diseases, rural population, India
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-396635DOI: 10.3390/antibiotics8030139ISI: 000489181000054PubMedID: 31491900OAI: oai:DiVA.org:uu-396635DiVA, id: diva2:1368696
Funder
Swedish Research Council, 521-2012-2889Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-08Bibliographically approved

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