Community-Based Surveillance of Antimicrobial Use and ...

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CONTENTSProject members .................................................................................................................................. vAcknowledgements.......................................................................................................................... viiAbbreviations...................................................................................................................................... ixHow this report is organized............................................................................................................. 1Executive summary ............................................................................................................................. 11. Background, aims and general methods .................................................................................. 51.1 Background and justification ............................................................................................ 51.2 Aims and objectives............................................................................................................ 71.3 Methods followed and rationale....................................................................................... 81.3.1 AMR data ................................................................................................................................ 91.3.2 ABM use ................................................................................................................................ 121.3.3 Comparison with larger‐scale, network programmes .................................................... 141.4 Approval for the study..................................................................................................... 152. Delhi, India .................................................................................................................................. 172.1 Background information on the site............................................................................... 172.2 Methods.............................................................................................................................. 172.2.1 AMR surveillance................................................................................................................. 172.2.2 ABM use ................................................................................................................................ 182.2.3 Data management ................................................................................................................ 192.3 Findings.............................................................................................................................. 192.3.1 AMR in E. coli........................................................................................................................ 192.3.2 ABM use ................................................................................................................................ 222.3.3 Effect of ABM on AMR........................................................................................................ 252.4 Lessons learnt from this site ............................................................................................ 262.4.1 AMR ....................................................................................................................................... 262.4.2 ABM use ................................................................................................................................ 263. Vellore, India ............................................................................................................................... 273.1 Background information on the site............................................................................... 273.2 Methods.............................................................................................................................. 273.2.1 AMR surveillance................................................................................................................. 273.2.2 ABM use ................................................................................................................................ 283.2.3 Data management ................................................................................................................ 293.3 Findings.............................................................................................................................. 293.3.1 AMR in E. coli........................................................................................................................ 293.3.2 ABM use ................................................................................................................................ 343.3.3 Effect of ABM on AMR........................................................................................................ 403.4 Lessons learnt from this site ............................................................................................ 433.4.1 AMR ....................................................................................................................................... 433.4.2 ABM use ................................................................................................................................ 434. Mumbai, India............................................................................................................................. 454.1 Background information on the site............................................................................... 454.2 Methods.............................................................................................................................. 454.2.1 AMR surveillance................................................................................................................. 454.2.2 ABM use ................................................................................................................................ 464.2.3 Data management ................................................................................................................ 46i
4.3 Findings.............................................................................................................................. 464.3.1 AMR in E. coli........................................................................................................................ 474.3.2 ABM use ................................................................................................................................ 504.3.3 Effect of ABM on AMR........................................................................................................ 544.4 Lessons learnt from this site ............................................................................................ 564.4.1 AMR ....................................................................................................................................... 564.4.2 ABM use ................................................................................................................................ 565. Brits, South Africa....................................................................................................................... 575.1 Background information on the site............................................................................... 575.2 Methods.............................................................................................................................. 575.2.1 AMR surveillance................................................................................................................. 575.2.2 ABM use ................................................................................................................................ 585.2.3 Data management ................................................................................................................ 585.3 Findings.............................................................................................................................. 585.3.1 AMR in E. coli........................................................................................................................ 585.3.2 ABM use ................................................................................................................................ 605.3.3 Effect of ABM on AMR........................................................................................................ 655.3.4 Compliance with the Standard Treatment Guidelines.................................................... 655.4 Lessons learnt from this site ............................................................................................ 665.4.1 AMR ....................................................................................................................................... 665.4.2 ABM use ................................................................................................................................ 666. Durban, South Africa ................................................................................................................. 696.1 Background information on the site............................................................................... 696.2 Method................................................................................................................................ 696.2.1 AMR ....................................................................................................................................... 696.2.2 ABM use ................................................................................................................................ 706.2.3 Data management ................................................................................................................ 716.3 Findings.............................................................................................................................. 716.3.1 AMR in potential respiratory pathogens .......................................................................... 716.3.2 ABM use ................................................................................................................................ 736.3.3 Effect of ABM on AMR........................................................................................................ 766.4 Lessons learntfrom this site ............................................................................................. 776.4.1 AMR ....................................................................................................................................... 776.4.2 ABM use ................................................................................................................................ 777. Summary of findings from all sites......................................................................................... 797.1 AMR.................................................................................................................................... 797.2 ABM use .............................................................................................................................817.3 ABM use and AMR........................................................................................................... 858. Lessons learnt and recommendations ....................................................................................... 878.1 Background .............................................................................................................. 878.2 Achievements........................................................................................................... 878.3 Lessons learnt concerning methodology.................................................................. 888.3.1 AMR ....................................................................................................................................... 888.3.2 ABM use – prescription data .............................................................................................. 918.3.3 ABM use ‐ bulk sales/purchase .......................................................................................... 948.3.4 AMR and ABM use .............................................................................................................. 958.3.5 General................................................................................................................................... 95ii
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