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乌干达新冠疫情期间社区对抗菌药物的购买情况:抗菌药物耐药性风险增加

Community purchases of antimicrobials during the COVID-19 pandemic in Uganda: An increased risk for antimicrobial resistance.

作者信息

Kiragga Agnes N, Najjemba Leticia, Galiwango Ronald, Banturaki Grace, Munyiwra Grace, Iwumbwe Idd, Atwine James, Ssendiwala Cedric, Natif Anthony, Nakanjako Damalie

机构信息

Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

African Population and Health Research Center, Nairobi, Kenya.

出版信息

PLOS Glob Public Health. 2023 Feb 23;3(2):e0001579. doi: 10.1371/journal.pgph.0001579. eCollection 2023.

Abstract

Self-Medication (SM) involves the utilization of medicines to treat self-recognized symptoms or diseases without consultation and the irrational use of over-the-counter drugs. During the COVID-19 pandemic, the lack of definitive treatment led to increased SM. We aimed to estimate the extent of SM for drugs used to treat COVID-19 symptoms by collecting data from pharmacy sale records. The study was conducted in Kampala, Uganda, where we extracted data from community pharmacies with functional Electronic Health Records between January 2018 and October 2021 to enable a comparison of pre-and post-COVID-19. The data included the number of clients purchasing the following drugs used to treat COVID-19 and its symptoms: Antibiotics included Azithromycin, Erythromycin, and Ciprofloxacin; Supplements included Zinc and vitamin C, while Corticosteroids included dexamethasone. A negative binomial model was used to estimate the incident rate ratios for each drug to compare the effect of COVID-19 on SM. In the pre- COVID-19 period (1st January 2018 to 11th March 2020), 19,285 customers purchased antibiotics which included; Azithromycin (n = 6077), Ciprofloxacin (n = 6066) and Erythromycin (n = 997); health supplements including Vitamin C (430) and Zinc (n = 138); and Corticosteroid including Dexamethasone (n = 5577). During the COVID-19 pandemic (from 15th March 2020 to the data extraction date in October 2021), we observed a 99% increase in clients purchasing the same drugs. The number of clients purchasing Azithromycin increased by 19.7% to 279, Ciprofloxacin reduced by 58.8% to 96 clients, and those buying Erythromycin similarly reduced by 35.8% to 492 clients. In comparison, there were increases of 170%, 181%, and 377% for Vitamin C, Zinc, and Dexamethasone, respectively. The COVID-19 pandemic underscored the extent of SM in Uganda. We recommend future studies with a representation of data from pharmacies located in rural and urban areas to further study pandemics' effect on antimicrobials prescriptions, including obtaining pharmacists' perspectives using mixed methods approaches.

摘要

自我药疗(SM)是指在没有咨询医生的情况下使用药物治疗自我识别的症状或疾病,以及不合理使用非处方药。在新冠疫情期间,由于缺乏明确的治疗方法,自我药疗的情况有所增加。我们旨在通过收集药房销售记录数据来估计用于治疗新冠症状的药物的自我药疗程度。该研究在乌干达坎帕拉进行,我们从2018年1月至2021年10月期间拥有功能正常的电子健康记录的社区药房提取数据,以便比较新冠疫情前后的情况。数据包括购买以下用于治疗新冠及其症状的药物的客户数量:抗生素包括阿奇霉素、红霉素和环丙沙星;补充剂包括锌和维生素C,而皮质类固醇包括地塞米松。使用负二项式模型来估计每种药物的发病率比,以比较新冠疫情对自我药疗的影响。在新冠疫情前时期(2018年1月1日至2020年3月11日),19285名客户购买了抗生素,其中包括:阿奇霉素(n = 6077)、环丙沙星(n = 6066)和红霉素(n = 997);健康补充剂包括维生素C(430)和锌(n = 138);以及皮质类固醇包括地塞米松(n = 5577)。在新冠疫情期间(从2020年3月15日至2021年10月的数据提取日期),我们观察到购买相同药物的客户增加了99%。购买阿奇霉素的客户数量增加了19.7%,达到279人,环丙沙星减少了58.8%,降至96人,购买红霉素的客户数量同样减少了35.8%,降至492人。相比之下,维生素C、锌和地塞米松的购买量分别增加了170%、181%和377%。新冠疫情凸显了乌干达自我药疗的程度。我们建议未来的研究纳入来自农村和城市地区药房的数据,以进一步研究疫情对抗菌药物处方的影响,包括使用混合方法获取药剂师的观点。

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