scholarly journals Drivers of Irrational Use of Antibiotics in Europe

2018 ◽  
Vol 16 (1) ◽  
pp. 27 ◽  
Author(s):  
Anna Machowska ◽  
Cecilia Stålsby Lundborg
Keyword(s):  
Antibiotic Resistance ◽  
Medical Training ◽  
Relevant Literature ◽  
Healthcare Providers ◽  
Antibiotic Use ◽  
World Health ◽  
Contributory Factor ◽  
New Perspective ◽  
Health Organization ◽  
Major Factors

The unnecessary use of antibiotics and concomitant rapid growth of antibiotic resistance (ABR) is a widely acknowledged threat to global health, development, and sustainability. While the underlying cause of ABR is undoubtedly the overall volume of antibiotic use in general, irrational antibiotic use, which is influenced by several interrelated factors, is a major contributory factor. Here, we aimed to present and describe selected main drivers of irrational use of antibiotics in Europe. We performed a broad search of the current literature in databases such as PubMed, Google Scholar, Cochrane, as well as various institutional websites (World Health Organization, European Observatory, European Commission) to provide a new perspective on selected drivers of irrational antibiotic use in Europe. We also searched for relevant literature using snowballing, i.e., using reference lists of papers to identify additional papers. In this narrative review, we present that major factors among the general public driving antibiotic resistance are lack of public knowledge and awareness, access to antibiotics without prescription and leftover antibiotics, and knowledge attitude and perception of prescribers and dispensers, inadequate medical training, pharmaceutical promotion, lack of rapid and sufficient diagnostic tests, and patient–doctor interaction as major factors among healthcare providers. We further discuss initiatives that, if taken and implemented, can have an impact on and improve the current situation in Europe.

scholarly journals Antibiotic resistance in European wastewater treatment plants mirrors the pattern of clinical antibiotic resistance prevalence

2019 ◽  
Vol 5 (3) ◽  
pp. eaau9124 ◽  
Author(s):  
Katariina M. M. Pärnänen ◽  
Carlos Narciso-da-Rocha ◽  
David Kneis ◽  
Thomas U. Berendonk ◽  
Damiano Cacace ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Wastewater Treatment ◽  
Wastewater Treatment Plants ◽  
Action Plan ◽  
Quantitative Polymerase Chain Reaction ◽  
Antibiotic Use ◽  
Control Measures ◽  
World Health ◽  
Global Action ◽  
Health Organization

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.

scholarly journals Evaluation of Knowledge and Risk Perception about Antibiotic Resistance in Biology and Mathematics Young Students in Nîmes University in France

2021 ◽  
Vol 18 (18) ◽  
pp. 9692
Author(s):  
Valentin Duvauchelle ◽  
Elsa Causse ◽  
Julien Michon ◽  
Patrick Rateau ◽  
Karine Weiss ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Risk Perception ◽  
Antibiotic Use ◽  
The Body ◽  
World Health ◽  
Resistance Risk ◽  
Similar Survey ◽  
Young Students ◽  
And Mathematics ◽  
Health Organization

In response to the antimicrobial resistance issue, the World Health Organization developed and conducted a survey in 2015 dealing with habits, antibiotic use, awareness of appropriate use and sensitization to the issue of antibacterial resistance. In France, we conducted a similar survey to investigate the use of antibiotics and students’ perceptions of the antibiotic resistance risk. Our results indicated that antibiotics are moderately taken (42% in the last six months), but mistakes remain in appropriate practices and knowledge. Many people still believe that the body develops resistance to antibiotics and 24% responded that antibiotics can be stopped before the end of the treatment if they feel better. Furthermore, only 14% said antibiotics could be used to treat gonorrhea while 57% indicated that influenza could be treated with antibiotics. We looked at risk perception as well, and noticed that students in biology were more aware of risk (mean score = 48.87) and health consequences (mean score = 40.33) than mathematics students (mean score = 44.11 and 37.44). They were more aware of the threat, had a better understanding of antibiotic resistance and their denial of this risk was less significant (mean score = 27.04 against 23.81). However, the importance of providing a minimum level of knowledge to young students has been emphasized, regardless of the field of expertise.

scholarly journals Antibiotic use: evaluating knowledge, attitude and practices among medical students in a sub Himalayan state

2017 ◽  
Vol 6 (10) ◽  
pp. 2516 ◽  
Author(s):  
Rajiv Kumar Gupta ◽  
Parveen Singh ◽  
Renu Rani ◽  
Rashmi Kumari ◽  
Bhavna Langer ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Medical Students ◽  
Viral Infections ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
World Health ◽  
Chi Square ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Health Organization

Background: The growing concern about antibiotic resistance, of late, led World Health Organization to declare it as World Health Day theme in 2011. Knowledge spreads awareness and understanding by melting the barriers of ignorance while attitudes and practices have a bearing on the health related behaviour. The present study aims at evaluating the knowledge, attitudes and practices of medical students towards antibiotic usage.Methods: The present cross-sectional study was conducted among the Pre-final medical students (6th / 7th semester) who participated in the questionnaire survey on knowledge, attitude and practice towards antibiotics usage. The data was analysed and Chi-square was used as test of significance.Results: Overall, 132 students were interviewed. Majority (96.2%) had heard of antibiotic resistance. About 22% of the sample stated that antibiotics can cure viral infections, among them female being in the higher proportion (p<0.05). Majority (>90%) agreed that antibiotic resistance is a serious problem and had positive attitude about population awareness campaign regarding antibiotic resistance. Among practices, higher proportion of male respondents preferred antibiotics in case of cough and sore throat. (p<0.05).Conclusions: Despite being Pre-final MBBS students, the results have revealed that knowledge and attitude of the respondents were not up to the desired levels. The practices regarding use of antibiotics were more or less adequate. For effective curriculum, thorough knowledge and rational prescription of antibiotics needs to be reinforced among medical students both before and during internship.

scholarly journals Engaging healthcare providers and patients on climate action through physical, emotional and social wellness

2022 ◽  
Vol 9 (1) ◽  
pp. 8-9
Author(s):  
Minna Allarakhia
Keyword(s):  
Climate Change ◽  
Medical Training ◽  
Healthcare Providers ◽  
Well Being ◽  
World Health ◽  
Sustainable Living ◽  
Vector Borne Diseases ◽  
Increased Risk ◽  
Climate Action ◽  
Health Organization

According to the World Health Organization, the health challenges from climate change are many and varied including: Malnutrition due to lack of quality food access. Mental health challenges in addition to severe socioeconomic challenges, through the loss of homes, jobs and needed social connections due to extreme events. Acute illness and the risk of water-borne diseases associated with lack of access to clean water. The increased risk of vector-borne diseases with warmer temperatures. Chronic illnesses associated with heat stress and pollution. Death from cardiovascular and respiratory disease, particularly among vulnerable people as temperatures rise to extreme levels. Both healthcare providers and patients must be engaged on climate change and action. While several medical training institutions are exploring opportunities to embed climate change and health education into their curricula, of importance are the holistic strategies to engage patients on climate action. The challenges are complex, and the data is overwhelming. Patients may not fully comprehend the personal implications of climate change and as citizens, may not understand their role in climate action. We suggest through the creation of a sustainable living mindset based on wellness, it is possible for healthcare providers to create a personal and emotional connection to climate action. The results from workshops with older adults are shared in this paper, demonstrating how the link to physical, emotional and social wellness, can encourage behavior change with respect to dietary and consumption practices as well as increased connection to and protection of greenspaces for health and well-being.  

scholarly journals Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

2020 ◽  
pp. 07-19
Author(s):  
Hiba Takieddine ◽  
Samaa AL Tabbah
Keyword(s):  
Healthcare Providers ◽  
Well Being ◽  
World Health ◽  
Vulnerable Groups ◽  
Public Health Response ◽  
New Normal ◽  
The World ◽  
Health Organization ◽  
The Impact

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

scholarly journals Smart Phone Apps for Smoking Cessation - A Qualitative Study among Healthcare Providers in Chennai

2021 ◽  
Vol 8 (21) ◽  
pp. 1630-1635
Author(s):  
Sree T. Sucharitha ◽  
Pradeep Rangasamy ◽  
Vaishikaa R ◽  
Balaji S.M ◽  
Bindu T ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Digital Literacy ◽  
Health Care Services ◽  
Tobacco Cessation ◽  
Healthcare Providers ◽  
Smart Phone ◽  
General Medicine ◽  
World Health ◽  
Brief Assessment ◽  
Health Organization

BACKGROUND Majority of smokers are aware of health consequences due to smoking but reported inability to quit smoking in multiple studies. Reasons attributed to continued smoking include multiple causes like addiction, habit and stress, as well as face-valid causes such as disease, personality problems, weakness of character, etc. Tobacco cessation services promoted by World Health Organization (WHO) are typically to be initiated by the service provider and include brief opportunistic assessment for smoking cessation widely known as 5A’ and 5R’s for brief assessment. Health interventions are identified by WHO as an effective way to enhance the promotion of tobacco cessation as only three percent of smokers manage to quit without help of intervention. This study explored the awareness of smart phone apps for smoking cessation among private healthcare providers in Chennai. METHODS A qualitative, explorative study through one-on-one, personal interviews among 36 randomly approached and consenting healthcare providers primarily providing tobacco related health care services including dentists, psychiatrists, ear – nose - throat surgeons, general medicine, respiratory medicine, surgeons and obstetricians at six private teaching medical institutes was conducted from July 2020 to October 2020 in Chennai. RESULTS The results showed that majority of the healthcare providers lack awareness of smart phone-based apps for smoking cessation. However, a very small minority3 who were aware were limited by social determinants of health of the clients such as perceived poor digital literacy, unaffordability of internet packages to recommend them. CONCLUSIONS The healthcare providers from various fields lacked the awareness of smart phone apps aiding with smoking cessation with the exception of a minor few3 who acknowledged their existence but were engaged very minimally with these modalities. KEYWORDS Healthcare Providers’ Awareness, Smart Phone Based-Apps, Smoking Cessation Apps, Tobacco Clients, Personal Interviews

scholarly journals Critical appraisal of Drug Promotional Literatures (DPLs) as per World Health Organization (WHO) guidelines

2018 ◽  
Vol 7 (2) ◽  
pp. 238
Author(s):  
Pratit P. Vyas ◽  
Amol L. Bhave
Keyword(s):  
Active Ingredient ◽  
Journal Article ◽  
Healthcare Providers ◽  
World Health ◽  
Pharmaceutical Companies ◽  
Who Guidelines ◽  
Cross Sectional ◽  
Therapeutic Uses ◽  
Safety Parameters ◽  
Health Organization

Background: The study was aimed to critically analyse Drug Promotional Literatures (DPLs) using WHO guidelines. This would help to create awareness about DPLs amongst healthcare providers thus encouraging the improvement of healthcare system.Methods: This cross sectional observational study was carried out at Department of Pharmacology, Medical College Baroda. DPLs were collected & critically analysed for consistency, accuracy, validity of the provided information as per WHO guidelines.Results: Out of total 616 DPLs collected, 371 satisfied the inclusion criteria. None of the DPL was fulfilling all criteria according to WHO guidelines. Most of DPLs were having information regarding; generic name / INN (98.39%), brand name (100%), amount of active ingredient per dosage (94.07%), approved therapeutic uses (84.91%), dosage form (91.37%) and name & address of manufacturers (91.91%). Of all the DPLs, information provided for safety parameters like; name of active ingredient known to cause problem (11.59%), dosage regimen (32.88%), side effects & drug reaction (14.56%), major drug interactions (14.02%) and precautions, contraindications and warning (14.29%) seemed to be grossly neglected. Total of 431 claims were evaluated, of which the most common type of claim was efficacy (55.45%). Relevant references to claims were present in (48.74%) DPLs. Total 203 references were evaluated from 371 DPLs, of which maximum reference were from journal article (74.38%).Conclusions: From this study, it was concluded that pharmaceutical companies didn’t follow the WHO guidelines for ethical drug promotion, thus failing to fulfil the rational promotion of drugs. Given the present findings physicians should be cautious about drawing conclusions regarding medicine based on DPLs provided by pharmaceutical companies.

scholarly journals Inclusion of palliative care teaching in medical schools in Brazil

2021 ◽  
Vol 45 (2) ◽  
Author(s):  
Andrea Augusta Castro ◽  
Stella Regina Taquette ◽  
Natan Iório Marques
Keyword(s):  
Palliative Care ◽  
Medical Training ◽  
National Curriculum ◽  
Medical Schools ◽  
World Health ◽  
Ministry Of Education ◽  
The North ◽  
Curriculum Guidelines ◽  
Legal Frameworks ◽  
Health Organization

Abstract: Introduction: The palliative care (PC) approach is a care modality recommended by the World Health Organization. Suffering and the process of dying are present in everyday clinical practice, affecting people with life-threatening diseases. However, the predominant model of teaching in Brazilian medical schools does not include palliative care. Objectives: The aim of the study was to get to know the Brazilian medical schools that include PC in their curriculum, and how it has been taught. Methods: Descriptive and exploratory study, carried out by searching for medical schools with disciplines in PC, through the analysis of the course syllabi available in the curricular matrices on the official websites of higher education institutions from August to December 2018. They were analyzed considering the offered period of the PC content, workload, scenario, and type of discipline (elective or mandatory). Results: 315 schools registered with the Ministry of Education were found, and only 44 of them (14%) offer courses in PC. These schools are distributed throughout 11 Brazilian states, of which 52% are located in the Southeast region, 25% in the Northeast, 18% in the South, 5% in the Midwest, and none in the North region. The predominant modality of the type of discipline in PC was mandatory in 61% of schools. Most Brazilian medical schools are private entities (57%), a similar percentage to the total number of medical schools identified with the teaching of PC. This course takes place in the 3rd and 4th years of the course; in most schools, the workload was 46,9 hours. The predominant scenario is the classroom, while some institutions provide integration between teaching community service and medical practice. The program contents are diverse, including thanatology, geriatrics and finitude, humanization, bioethics, pain, oncology and chronic diseases. Conclusion: PC education in Brazil is insufficient, which represents a barrier to the training of doctors in line with the recommendations of international entities, the National Curriculum Guidelines and legal frameworks within the scope of SUS. Investments by medical entities and government agencies are necessary to increase teaching in PC and the consequent qualification of medical training.

Use of the World Health Organization Access, Watch, and Reserve Classification to Follow Trends in Prescription of Antibiotic Use in Two Pediatric Intensive Care Units in Rio de Janeiro, Brazil

2020 ◽  
Vol 15 (03) ◽  
pp. 155-160
Author(s):  
André Ricardo Araujo da Silva ◽  
Cristina Vieira de Souza Oliveira ◽  
Cristiane Henriques Teixeira ◽  
Izabel Alves Leal
Keyword(s):  
Time Series ◽  
Intensive Care ◽  
Time Series Analysis ◽  
World Health Organization ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
World Health ◽  
The World ◽  
Health Organization

Abstract Objective The recommended percentage of antibiotic use in pediatric intensive care units (PICUs) using the World Health Organization (WHO) Access, Watch, and Reserve (AWaRE) classification is not known. Methods We have conducted an interrupted time series analysis in two PICUs in Rio de Janeiro, Brazil, over a period of 18 months. The type of antibiotics used was evaluated using the WHO AWaRE classification, and the amount of antibiotic was measured using days of therapy/1,000 patient-days (DOT/1000PD) after implementation of an antimicrobial stewardship program (ASP). The first and last semesters were compared using medians and the Mann–Whitney's test. The trends of antibiotic consumption were performed using time series analysis in three consecutive 6-month periods. Results A total of 2,205 patients were admitted, accounting for 12,490 patient-days. In PICU 1, overall antibiotic consumption (in DOT/1000PD) was 1,322 in the first 6 months of analysis and 1,264.5 in the last 6 months (p = 0.81). In PICU 2, the consumption for the same period was 1,638.5 and 1,344.5, respectively (p = 0.031). In PICU 1, the antibiotics classified in the AWaRE groups were used 33.2, 57.9, and 8.4% of the time, respectively. The remaining 0.5% of antibiotics used were not classified in any of these groups. In PICU 2, the AWaRE groups corresponded to 30.2, 60.5, and 9.3% of all antibiotics used, respectively. There was no use of unclassified antibiotics in this unit. The use of all three groups of WHO AWaRE antibiotics was similar in the first and the last semesters, with the exception of Reserve group in PICU 2 (183.5 × 92, p = 0.031). Conclusion A significant reduction of overall antibiotic use and also in the Reserve group was achieved in one of the PICU units studied. The antibiotics classified in the Watch group were the most used in both units, representing ∼60% of all the antibiotics consumed.

scholarly journals Antiplasmodial natural products: an update

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Nasir Tajuddeen ◽  
Fanie R. Van Heerden
Keyword(s):  
Natural Products ◽  
Relevant Literature ◽  
World Health ◽  
Effective Control ◽  
Insecticide Treated Nets ◽  
Scientific Databases ◽  
The World ◽  
Significant Public Health ◽  
Public Health Challenge ◽  
Health Organization

Abstract Background Malaria remains a significant public health challenge in regions of the world where it is endemic. An unprecedented decline in malaria incidences was recorded during the last decade due to the availability of effective control interventions, such as the deployment of artemisinin-based combination therapy and insecticide-treated nets. However, according to the World Health Organization, malaria is staging a comeback, in part due to the development of drug resistance. Therefore, there is an urgent need to discover new anti-malarial drugs. This article reviews the literature on natural products with antiplasmodial activity that was reported between 2010 and 2017. Methods Relevant literature was sourced by searching the major scientific databases, including Web of Science, ScienceDirect, Scopus, SciFinder, Pubmed, and Google Scholar, using appropriate keyword combinations. Results and Discussion A total of 1524 compounds from 397 relevant references, assayed against at least one strain of Plasmodium, were reported in the period under review. Out of these, 39% were described as new natural products, and 29% of the compounds had IC50 ≤ 3.0 µM against at least one strain of Plasmodium. Several of these compounds have the potential to be developed into viable anti-malarial drugs. Also, some of these compounds could play a role in malaria eradication by targeting gametocytes. However, the research into natural products with potential for blocking the transmission of malaria is still in its infancy stage and needs to be vigorously pursued.

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