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Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales.
Kliemann, Breno S; Levin, Anna S; Moura, M Luísa; Boszczowski, Icaro; Lewis, James J.
Afiliação
  • Kliemann BS; Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Levin AS; Course of Medicine, Health Sciences Sector, Federal University of Paraná, Curitiba, Brazil.
  • Moura ML; Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
  • Boszczowski I; Department of Infectious Diseases and LIM54, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
  • Lewis JJ; Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.
PLoS One ; 11(12): e0167885, 2016.
Article em En | MEDLINE | ID: mdl-27941993
BACKGROUND: Improper antibiotic use is one of the main drivers of bacterial resistance to antibiotics, increasing infectious diseases morbidity and mortality and raising costs of healthcare. The level of antibiotic consumption has been shown to vary according to socioeconomic determinants (SED) such as income and access to education. In many Latin American countries, antibiotics could be easily purchased without a medical prescription in private pharmacies before enforcement of restrictions on over-the-counter (OTC) sales in recent years. Brazil issued a law abolishing OTC sales in October 2010. This study seeks to find SED of antibiotic consumption in the Brazilian state of São Paulo (SSP) and to estimate the impact of the 2010 law. METHODS: Data on all oral antibiotic sales having occurred in the private sector in SSP from 2008 to 2012 were pooled into the 645 municipalities of SSP. Linear regression was performed to estimate consumption levels that would have occurred in 2011 and 2012 if no law regulating OTC sales had been issued in 2010. These values were compared to actual observed levels, estimating the effect of this law. Linear regression was performed to find association of antibiotic consumption levels and of a greater effect of the law with municipality level data on SED obtained from a nationwide census. RESULTS: Oral antibiotic consumption in SSP rose from 8.44 defined daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010, and fell to 8.06 DID in 2012. Determinants of a higher consumption were higher human development index, percentage of urban population, density of private health establishments, life expectancy and percentage of females; lower illiteracy levels and lower percentage of population between 5 and 15 years old. A higher percentage of females was associated with a stronger effect of the law. CONCLUSIONS: SSP had similar antibiotic consumption levels as the whole country of Brazil, and they were effectively reduced by the policy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Uso de Medicamentos / Legislação de Medicamentos / Antibacterianos Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Uso de Medicamentos / Legislação de Medicamentos / Antibacterianos Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: Estados Unidos