Pattern of antibiotic use in a trachoma-endemic region of Nepal: implications for mass azithromycin distribution
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Updated: Aug 31, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Vivian Schiedler1, Ramesh C Bhatta, Yinghui Miao
1F.I. Proctor Foundation and the Department of Ophthalmology, University of California at San Francisco, 94143-0944, USA.
Purpose:
To investigate antibiotic utilization in a rural district of western Nepal that is currently receiving azithromycin as part of a trachoma program and is being monitored by the Centers for Disease Control and Prevention (CDC) for drug resistance.
Methods:
Antibiotic purchase receipts were collected for 3 months from all medicine halls, pharmacies, and government sub-health posts in a sub-district of Western Nepal. Supplementary surveys of antibiotic sales were performed in different seasons.
Results:
Macrolides account for 3.9% of total antibiotic use, far less than quinolones, penicillins, tetracyclines, and sulfonamides.
Conclusions:
If trachoma programs in Western Nepal generate transient macrolide resistance in pneumococcus and other bacteria, the epidemiological impact may not be great, as macrolides are not commonly used in the area.
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