London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, United Kingdom.
The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, United Kingdom.
J Antibiot (Tokyo). 2021 Jun;74(6):417-420. doi: 10.1038/s41429-021-00416-3. Epub 2021 Mar 19.
Since the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income countries. This study collected data on the antibiotics stocked in human (42) and veterinary (21) drug shops in five sub-counties in Luwero district of Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Specifically, chloramphenicol products licensed for human use were being administered to Ugandan poultry. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. By limiting the health sector scope of antimicrobial resistance research to either human or animal antibiotic use, results can falsely inform policy and intervention strategies. Therefore, a One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action.
自抗生素被引入主流医疗保健以来，这些药物的耐药性已成为一个广泛存在且不断加剧的全球性问题。由于缺乏关于低收入国家抗生素产品供应和使用情况的监测数据，减轻抗生素耐药性发展的政策决策受到了阻碍。本研究在乌干达卢韦罗区的五个分区收集了人类（42 种）和兽医（21 种）药店库存抗生素的数据。还采用了与药店供应商的焦点小组讨论来探索社区中的抗生素使用情况。焦点小组参与者报告说，农民将用于人类的抗生素用于他们的牲畜，而社区成员则将用于动物的抗生素用于自己的个人用途。具体来说，用于人类的氯霉素产品被用于乌干达家禽。通过当地动物产品摄入氯霉素残留会对公共健康造成严重威胁。如果将抗生素耐药性研究的卫生部门范围仅限于人类或动物抗生素的使用，那么结果可能会错误地为政策和干预策略提供信息。因此，需要采取一种“同一健康”方法来了解社区抗生素使用的更广泛影响，从而提高干预政策和监管行动的整体效果。
