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Brazil's resolutions to regulate the sale of antibiotics: Impact on consumption and Escherichia coli resistance rates.
Mattos, Karen P H; Visacri, Marília B; Quintanilha, Júlia C F; Lloret, Gustavo R; Cursino, Maria A; Levin, Anna S; Levy, Carlos E; Moriel, Patricia.
Afiliación
  • Mattos KPH; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Visacri MB; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Quintanilha JCF; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Lloret GR; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Cursino MA; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Levin AS; Infection Control Department of Hospital das Clínicas and Department of Infectious Diseases of Faculty of Medicine, University of São Paulo, 618, Banibas Street, 05460-010 Sao Paulo, SP, Brazil.
  • Levy CE; School of Medical Sciences, University of Campinas, 126, Tessália Vieira de Camargo Street, 13083-887 Campinas, SP, Brazil.
  • Moriel P; Faculty of Pharmaceutical Sciences, University of Campinas, 200, Cândido Portinari Street, 13083-871 Campinas, SP, Brazil. Electronic address: patricia.moriel@fcf.unicamp.br.
J Glob Antimicrob Resist ; 10: 195-199, 2017 09.
Article en En | MEDLINE | ID: mdl-28735057
OBJECTIVE: The aim of this study was to determine the impact of two resolutions to restrict antibiotic use (RDCs no. 44/2010 and 20/2011) in the Campinas metropolitan area (Sao Paulo, Brazil) on antibiotic consumption, resistance rates, and trends in Escherichia coli-causing community-acquired urinary tract infection (UTI). METHODS: The annual retail sale information of antibiotics from drugstores in the Campinas metropolitan area between 2008 and 2012 were obtained through the Intercontinental Medical Statistics Health of Brazil. The daily-defined dose (DDD)/1000 inhabitants/day was calculated from these data to measure consumption. To examine resistance rates, we performed an observational retrospective study in a Campinas teaching hospital, where urinary cultures from outpatients with a clinical suspicion of UTI between October 2009 and September 2015 were analyzed. RESULTS: We observed an increase in rates of antibiotic sales from 2008 to 2011 (cephalosporin: 216.8%, quinolones: 170.9%, aminopenicillins: 140.9%), followed by a decrease in sales in 2012 (cephalosporin: 19.4%, quinolones: 12.7%, aminopenicillins: 11.1%). Sale of nitrofurans, however, did not significantly change during this period. In the retrospective analysis, we observed a significant increasing trend of E. coli resistance for all antibiotic classes, except nitrofurans and folate pathway inhibitors. CONCLUSIONS: We found changes in antibiotic consumption, with an initial increase, followed by a decrease in sales after implementation of the resolutions. However, bacterial resistance does not appear to be affected by the RDCs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comercio / Farmacorresistencia Bacteriana / Utilización de Medicamentos / Escherichia coli / Antibacterianos Tipo de estudio: Observational_studies Límite: Humans País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Glob Antimicrob Resist Año: 2017 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Comercio / Farmacorresistencia Bacteriana / Utilización de Medicamentos / Escherichia coli / Antibacterianos Tipo de estudio: Observational_studies Límite: Humans País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Glob Antimicrob Resist Año: 2017 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Países Bajos