scholarly journals Antibiotic consumption at community pharmacies: A multicenter repeated prevalence surveillance using WHO methodology

2021 ◽  
Vol 5 ◽  
pp. 239920262110647
Author(s):  
Zikria Saleem ◽  
Erwin Martinez Faller ◽  
Brian Godman ◽  
Muhammad Sajeel Ahmed Malik ◽  
Aqsa Iftikhar ◽  
...  
Keyword(s):  
Action Plan ◽  
Antibiotic Consumption ◽  
World Health ◽  
Resistant Bacteria ◽  
Published Data ◽  
Community Pharmacies ◽  
Prevalence Survey ◽  
Defined Daily Doses ◽  
Consumption Data ◽  
Health Organization

Background: Antibiotics are losing their effectiveness because of the rapid emergence of resistant bacteria. Unnecessary antimicrobial use increases antimicrobial resistance (AMR). There are currently no published data on antibiotic consumption in Pakistan at the community level. This is a concern given high levels of self-purchasing of antibiotics in Pakistan and variable knowledge regarding antibiotics and AMR among physicians and pharmacists. Objective: The objective of this repeated prevalence survey was to assess the pattern of antibiotic consumption data among different community pharmacies to provide a baseline for developing future pertinent initiatives. Methods: A multicenter repeated prevalence survey conducted among community pharmacies in Lahore, a metropolitan city with a population of approximately 10 million people, from October to December 2017 using the World Health Organization (WHO) methodology for a global program on surveillance of antimicrobial consumption. Results: The total number of defined daily doses (DDDs) dispensed per patient ranged from 0.1 to 50.0. In most cases, two DDDs per patient were dispensed from pharmacies. Co-amoxiclav was the most commonly dispensed antibiotic with a total number of DDDs at 1018.15. Co-amoxiclav was followed by ciprofloxacin with a total number of 486.6 DDDs and azithromycin with a total number of 472.66 DDDs. The least consumed antibiotics were cefadroxil, cefotaxime, amikacin, and ofloxacin, with overall consumption highest in December. Conclusion: The study indicated high antibiotic usage among community pharmacies in Lahore, Pakistan particularly broad-spectrum antibiotics, which were mostly dispensed inappropriately. The National action plan of Pakistan on AMR should be implemented by policymakers including restrictions on the dispensing of antimicrobials.

scholarly journals Decreasing Trends in Antibiotic Consumption in Public Hospitals from 2014 to 2017 Following the Decentralization of Drug Procurement in Myanmar

2021 ◽  
Vol 6 (2) ◽  
pp. 57
Author(s):  
Khin Hnin Pwint ◽  
Kyaw Soe Min ◽  
Wenjing Tao ◽  
Hemant Deepak Shewade ◽  
Khin Thet Wai ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Consumption ◽  
Public Hospitals ◽  
World Health ◽  
Beta Lactam ◽  
Drug Procurement ◽  
Pull System ◽  
Defined Daily Doses ◽  
Health Organization ◽  
Over Time

(1) Background: In 2014, drug procurement for public hospitals in Myanmar was decentralized to a pull system. This might lead to increasing trends in the consumption of broad-spectrum and last-resort antibiotics. For fiscal years 2014-2017, we assessed annual antibiotic consumption trends and patterns in total defined daily doses (DDDs). (2) Methods: We followed World Health Organization (WHO) methodology for surveillance of antimicrobial consumption based on hospital antibiotic procurement records (as a proxy). (3) Results: In 32% of all public hospitals where data were retrieved, total antibiotic consumption reduced by 19% between 2014 (7,122,852 DDD) and 2017 (5,794,904 DDD). Consumption per 1000 inhabitants per day (<200 bed hospitals) also reduced from 0.6 to 0.3. Over 60% of procurement was for beta-lactam antibiotics and quinolones; quinolones decreased over time. Consumption of first-line antibiotics increased (42% in 2014 to 54% in 2017), whereas broad-spectrum antibiotics decreased (46% in 2014 to 38% in 2017). Linezolid was the only last-resort antibiotic procured. There was a progressive reduction in per capita government current health expenditure from approximately 9.2 US$ in 2014 to 8.3 US$ in 2017. (4) Conclusions: Antibiotic consumption decreased over time in public hospitals. This first study provides a baseline for developing an antibiotic consumption surveillance system in Myanmar.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

scholarly journals Gold Nanoparticles: Can They Be the Next Magic Bullet for Multidrug-Resistant Bacteria?

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 312
Author(s):  
Mohammad Okkeh ◽  
Nora Bloise ◽  
Elisa Restivo ◽  
Lorenzo De Vita ◽  
Piersandro Pallavicini ◽  
...  
Keyword(s):  
Gold Nanoparticles ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Magic Bullet ◽  
Global Challenge ◽  
Gold Silver ◽  
Inorganic Nanomaterials ◽  
Health Organization

In 2017 the World Health Organization (WHO) announced a list of the 12 multidrug-resistant (MDR) families of bacteria that pose the greatest threat to human health, and recommended that new measures should be taken to promote the development of new therapies against these superbugs. Few antibiotics have been developed in the last two decades. Part of this slow progression can be attributed to the surge in the resistance acquired by bacteria, which is holding back pharma companies from taking the risk to invest in new antibiotic entities. With limited antibiotic options and an escalating bacterial resistance there is an urgent need to explore alternative ways of meeting this global challenge. The field of medical nanotechnology has emerged as an innovative and a powerful tool for treating some of the most complicated health conditions. Different inorganic nanomaterials including gold, silver, and others have showed potential antibacterial efficacies. Interestingly, gold nanoparticles (AuNPs) have gained specific attention, due to their biocompatibility, ease of surface functionalization, and their optical properties. In this review, we will focus on the latest research, done in the field of antibacterial gold nanoparticles; by discussing the mechanisms of action, antibacterial efficacies, and future implementations of these innovative antibacterial systems.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

scholarly journals Antibiotic Pipeline Coordinators

2018 ◽  
Vol 46 (S1) ◽  
pp. 25-31 ◽  
Author(s):  
Enrico Baraldi ◽  
Olof Lindahl ◽  
Miloje Savic ◽  
David Findlay ◽  
Christine Årdal
Keyword(s):  
Research And Development ◽  
World Health ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Priority List ◽  
Non Profit ◽  
Global Priority ◽  
The World ◽  
New Antibiotics ◽  
Health Organization

The World Health Organization (WHO) has published a global priority list of antibiotic-resistant bacteria to guide research and development (R&D) of new antibiotics. Every pathogen on this list requires R&D activity, but some are more attractive for private sector investments, as evidenced by the current antibacterial pipeline. A “pipeline coordinator” is a governmental/non-profit organization that closely tracks the antibacterial pipeline and actively supports R&D across all priority pathogens employing new financing tools.

scholarly journals DEFCON 5: The Chris Hani Baragwanath Academic Hospital orthopaedic department's COVID-19 proactive action plan

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
A Hirschmann ◽  
T Pillay ◽  
KW Fang ◽  
MT Ramokgopa ◽  
C Frey
Keyword(s):  
Orthopaedic Surgery ◽  
Action Plan ◽  
World Health ◽  
Global Public Health ◽  
Academic Hospital ◽  
Level Of Evidence ◽  
Staff Members ◽  
Level 3 ◽  
Health Organization ◽  
Multi Phase

ABSTRACT BACKGROUND: On 11 March 2020 the World Health Organization (WHO) declared COVID-19 a worldwide pandemic and a threat to global public health. In this paper we aim to describe the measures implemented to combat the COVID-19 pandemic in the Department of Orthopaedic Surgery at Chris Hani Baragwanath Academic Hospital (CHBAH), Soweto, Johannesburg, the largest hospital in Africa with approximately 3 200 beds and about 6 760 staff members. At the time of writing this report, we have transitioned from level 5 to level 3 lockdown METHODS: We performed a literature review and drew on the experiences of previous pandemic response plans worldwide. A working group comprising all relevant disciplines was created to develop standard operating procedures in line with governmental policy RESULTS: We found that by developing a multi-phase plan, we were able to maintain service delivery to all emergent patients while protecting medical staff and patients alike. This plan also allowed coordination with other disciplines and made provision for staff from within the Department of Orthopaedic Surgery to be made available to work within other departments as and when required. The implementation of this plan had to evolve constantly, adjusting to the changes in the national lockdown level and the demands of the developing situation CONCLUSION: We hope that by sharing our plan with our colleagues domestically and abroad, we can promote discussion and improve our ability to better prepare and deal with this unprecedented healthcare scenario. In order for us to win as individuals, we must fight as a team Level of evidence: Level 5 Keywords: COVID-19, orthopaedics, plan, response, Baragwanath

scholarly journals Coronavirus Disease 2019 Occupational Considerations for Surgeons: A Review Article

2021 ◽  
Vol 10 (1) ◽  
pp. 36-41
Author(s):  
Seyed Hesamaddin Banihashemi ◽  
Ahmadreza Karimi ◽  
Hasti Nikourazm ◽  
Behnaz Bahmanyar ◽  
Dariush Hooshyar
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Medical Staff ◽  
Review Article ◽  
World Health ◽  
Published Data ◽  
Rapid Spread ◽  
The World ◽  
Health Organization ◽  
And Control

The severe acute respiratory syndrome coronavirus 2 virus and its associated disease, called coronavirus disease 2019 (COVID-19), first appeared in Wuhan, China in December 2019 and quickly spread around the world. Coronavirus was officially named COVID-19 by the World Health Organization and was recognized as a pandemic due to its rapid spread worldwide. Based on the published data, it is hoped to provide a source for later studies and to help prevent and control the contagious COVID-19 and its characteristics, and considerations that surgeons and medical staff must observe during the epidemic.

scholarly journals Global Governance of Anti-microbial Resistance: A Legal and Regulatory Toolkit

2020 ◽  
pp. 401-420
Author(s):  
Calvin W. L. Ho ◽  
Tsung-Ling Lee
Keyword(s):  
Public Health ◽  
System Approach ◽  
Action Plan ◽  
World Health ◽  
Health Concern ◽  
Global Public Health ◽  
Agricultural Industry ◽  
Treatment And Prevention ◽  
Global Action ◽  
Health Organization

Abstract Recognizing that antimicrobial resistance (AMR) poses a serious threat to global public health, the World Health Organization (WHO) has adopted a Global Action Plan (GAP) at the May 2015 World Health Assembly. Underscoring that systematic misuse and overuse of drugs in human medicine and food production is a global public health concern, the GAP-AMR urges concerted efforts across governments and private sectors, including pharmaceutical industry, medical professionals, agricultural industry, among others. The GAP has a threefold aim: (1) to ensure a continuous use of effective and safe medicines for treatment and prevention of infectious diseases; (2) to encourage a responsible use of medicines; and (3) to engage countries to develop their national actions on AMR in keeping with the recommendations. While the GAP is a necessary step to enable multilateral actions, it must be supported by effective governance in order to realize the proposed aims. This chapter has a threefold purpose: (1) To identify regulatory principles embedded in key WHO documents relating to AMR and the GAP-AMR; (2) To consider the legal and regulatory actions or interventions that countries could use to strengthen their regulatory lever for AMR containment; and (3) To highlight the crucial role of the regulatory lever in enabling other levers under a whole-of-system approach. Effective AMR containment requires a clearer understanding of how the regulatory lever could be implemented or enabled within health systems, as well as how it underscores and interacts with other levers within a whole-of-system approach.

scholarly journals High global consumption of potentially inappropriate fixed dose combination antibiotics: Analysis of data from 75 countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0241899
Author(s):  
Barbara Bortone ◽  
Charlotte Jackson ◽  
Yingfen Hsia ◽  
Julia Bielicki ◽  
Nicola Magrini ◽  
...  
Keyword(s):  
The United States ◽  
Antibiotic Consumption ◽  
Essential Medicines ◽  
World Health ◽  
Fixed Dose ◽  
Middle Income ◽  
Us Fda ◽  
Analysis System ◽  
Health Organization ◽  
Data Analysis System

Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antimicrobial resistance (AMR) and toxicity. We used a pharmaceutical database, IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS®), to estimate sales of antibiotic FDCs from 75 countries in 2015. Antibiotic consumption was estimated using standard units (SU), defined by IQVIA as a single tablet, capsule, ampoule, vial or 5ml oral suspension. For each FDC antibiotic, the approval status was assessed by either registration with the United States Food and Drug Administration (US FDA) or inclusion on the World Health Organization (WHO) Essential Medicines List (EML). A total of 119 antibiotic FDCs were identified, contributing 16.7 x 109 SU, equalling 22% of total antibiotic consumption in 2015. The most sold antibiotic FDCs were amoxicillin-clavulanic acid followed by trimethoprim/sulfamethoxazole and ampicillin/cloxacillin. The category with the highest consumption volume was aminopenicillin/β-lactamase inhibitor +/- other agents. The majority of antibiotic FDCs (92%; 110/119) were not approved by the US FDA. Of these, the most sold were ampicillin/cloxacillin, cefixime/ofloxacin and metronidazole/spiramycin. More than 80% (98/119) of FDC antibiotics were not compatible with the 2017 WHO EML. The countries with the highest numbers of FDC antibiotics were India (80/119), China (25/119) and Vietnam (19/119). There is high consumption of FDC antibiotics globally, particularly in middle-income countries. The majority of FDC antibiotic were not approved by either US FDA or WHO EML. International initiatives such as clear guidance from the WHO EML on which FDCs are not appropriate may help to regulate the manufacturing and sales of these antibiotics.

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