Kotwani Anita, Holloway Kathleen, Chaudhury R R
Department of Pharmacology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
Indian J Med Res. 2009 May;129(5):555-60.
BACKGROUND & OBJECTIVE: Determining antibiotic use in the population is problematic in India, as there are no population level databases on prescriptions and over-the-counter sales. This study attempts to establish a methodology for surveillance of antibiotic use in the community.
Antibiotic use was monitored in fi ve municipal wards of Delhi, from January-December 2004. Thirty co-operative retail pharmacies were enrolled in Inderpuri (7), Karol Bagh (3), Patel Nagar (5), Rajinder Nagar (6) and Rajouri Garden (9); data on antibiotic use were collected in two ways. Firstly, bulk purchase data were collected by recording the quantities of all antibiotics purchased by these pharmacies every month over one year. Secondly, 15-25 'exit interviews' were conducted with patients leaving the enrolled pharmacies every month. Antibiotic use from bulk purchase data was measured as defined daily dose (DDD)/1000 population and from exit interview data as DDD/1000 patients visiting the pharmacy during data collection and also as per cent patients receiving an antibiotic.
Bulk purchase and exit interview data showed some similar patterns of antibiotic use with a growing peak in the consumption of most antibiotics classes in the months of February and March. Use of the fluoroquinolone group (J01MA) was much higher than other antibiotic classes by both methods. Exit interviews revealed that 21 per cent of persons who visited the pharmacies bought antibiotics. Both measures of use from exiting patient interviews showed the same trend over time.
INTERPRETATION & CONCLUSION: Both drug use methods can be used to measure antibiotic use in the private retail pharmacies and outpatient department of public facilities. Surveillance of antimicrobial drug use from private retail pharmacies in a municipal zone in Delhi indicated overuse of antimicrobial drugs, particularly fluoroquinolines.
在印度，由于缺乏有关处方和非处方销售的人群水平数据库，确定人群中的抗生素使用情况存在问题。本研究试图建立一种社区抗生素使用监测方法。
2004年1月至12月，在德里的五个市政病房监测抗生素使用情况。在因德尔普里（7家）、卡罗尔巴格（3家）、帕特尔纳加尔（5家）、拉金德纳加尔（6家）和拉朱里花园（9家）登记了30家合作零售药店；通过两种方式收集抗生素使用数据。首先，通过记录这些药店在一年中每月购买的所有抗生素数量来收集批量采购数据。其次，每月对离开登记药店的患者进行15 - 25次“出院访谈”。批量采购数据中的抗生素使用量以限定日剂量（DDD）/1000人口来衡量，出院访谈数据中的抗生素使用量以数据收集期间访问药店的患者的DDD/1000患者来衡量，也以接受抗生素治疗的患者百分比来衡量。
批量采购和出院访谈数据显示出一些相似的抗生素使用模式，大多数抗生素类别的消费量在2月和3月出现增长高峰。两种方法都显示氟喹诺酮类（J01MA）的使用远高于其他抗生素类别。出院访谈显示，访问药店的人中21%购买了抗生素。出院患者访谈的两种使用量度随时间显示出相同趋势。
两种药物使用方法均可用于衡量私人零售药店和公共设施门诊部的抗生素使用情况。对德里一个市政区域内私人零售药店的抗菌药物使用监测表明抗菌药物存在过度使用情况，尤其是氟喹诺酮类。
