了解社区药房的抗生素采购实践:新兴抗菌素耐药性的潜在驱动力
Abdullah Al Masud1, Ramesh Lahiru Walpola2, Malabika Sarker3,4
1School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Exploratory research in clinical and social pharmacy
|September 25, 2024
概括
抗生素耐药性是低收入国家的主要威胁,在孟加拉国,许多抗生素在没有处方的情况下销售. 干预措施必须解决容易获得和寻求医疗保健的行为,以打击不适当的抗生素使用.
科学领域:
- 全球健康 全球健康
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 抗菌素耐药性 (AMR) 构成了全球健康的重大威胁,特别是在低收入和中等收入国家 (LMICs).
- 在孟加拉国,低于最佳的医疗标准和不受监管的抗生素销售加剧了AMR的风险.
- 社区药房是LMICs抗生素使用的主要来源,有很高的不适当发行百分比.
研究的目的:
- 对孟加拉国社区药房的抗生素分发模式进行审计.
- 为了确定影响抗生素购买行为的因素.
- 为抗微生物药物管理提供有针对性的干预信息.
主要方法:
- 在孟加拉国,一项涉及385名抗生素消费者和1000名观察到的分发事件的横截面研究.
- 对抗生素使用模式的描述性分析.
- 普森回归来分析患者人口统计和健康症状对处方行为的影响.
主要成果:
- 抗生素占观察到的发放事件的25.9%,其中宏类和类是常见的.
- 超过一半 (56.6%) 的抗生素是无处方购买的,主要用于不严重的感染.
- 年轻人 (6-59岁) 与老年人或非常年轻人相比,不太可能提出处方.
结论:
- 没有处方的不受监管的抗生素销售普遍存在,需要根据当地寻求健康的做法进行调整的干预措施.
- 强制执行仅需处方的法规是具有挑战性的,因为易于访问和潜在的利益冲突.
- 未来的战略必须考虑药房人员的财务激励,并为最佳的抗生素管理建立明确的权威范围.
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