Community-Based Surveillance of Antimicrobial Use and ...

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3. Vellore, IndiaFig. 3.3 (A-B): Percentage of prescriptions containing any ABM in rural and urban areasin phases 1a and 1b (2003-2005)% prescriptions with ABM8070605040302010A1. Rural facilities (2003 - 2004)Hospital*Private pharmacyPrivate GPAverage% prescriptions with ABM8070605040302010A2. Rural facilites (2005)Hospital*Private pharmacyPrivate GPAverage0Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul0Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec% prescriptions with ABM80706050403020100B1. Urban facilities (2003-2004)Hospital*Private pharmacyPrivate GPAverageAug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul% prescriptions with ABM80706050403020100B2. Urban facilities (2005)Hospital*Private pharmacyPrivate GPAverageJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec* Not‐for‐profit and for‐profit hospitals in the urban area; public sector primary health care clinics and a notfor‐profithospital in the rural area3.3.2.2 Specific ABM use over timeData showing the use of major ABM classes are represented in Figures 3.4 and 3.5, asmeasured by the percentage of prescriptions containing an ABM from that class as well asexpressed as DDD per 100 patients seen. Both measures show high levels of use offluoroquinolones and extended‐spectrum penicillins (or cephalosporins), particularly inurban settings, but also high levels of cotrimoxazole use in the public sector PHC clinics andRUHSA mission hospital in the rural area. Prescriptions filled in private sector pharmaciesalso reflect the prescribing habits of private medical practitioners in the area. Markeddifferences in ABM choice were seen between private practitioners and the governmentclinics and mission hospital. By using both measures of ABM use, it is possible to seedifferences in the scale of exposure. For example, although the percentage of prescriptionsincluding a fluoroquinolone was similar in the rural and urban private practice settings, thenumber of DDD per 100 patients seen was much higher in the urban areas, reflectingdifferences in the doses and quantities prescribed.35
Community-based surveillance of antimicrobial useand resistance in resource-constrained settingsFig. 3.4 (A-B): Annual use of ABMs by facility type measured as percentage of prescriptionscontaining a specific ABMPhase 1a Aug 2003 - Jul 2004 Phase 1b Jan 2005 - Dec 2005% prescriptions with ABM40302010A1. Urban facilitiesPrivate pharmacyHospital*Private GP% prescriptions with ABM40302010A2. Urban facilitiesPrivate pharmacyHospital*Private GP0BLRP Macro Ceph ESP Flquin Cotrim Tetra0BLRP Ceph ESP Flquin Macro Cotrim Tetra% prescriptions with ABM403020100B1. Rural facilitiesPrivate pharmacyHospital*Private GPBLRP Macro Ceph ESP Flquin Cotrim Tetra% prescriptions with ABM403020100B2. Rural facilitiesPrivate pharmacyHospital*Private GPBLRP Ceph ESP Flquin Macro Cotrim Tetra* Not‐for‐profit and for‐profit hospitals in the urban area; public sector primary health care clinics and a notfor‐profithospital in the rural areaFig. 3.5 (A-B): Annual use of ABMs by facility type measured as no.DDDs of specific ABM prescribedper 100 patientsPhase 1a Aug 2003 - Jul 2004 Phase 1b Jan 2005 - Dec 2005% prescriptions with ABM100806040200A1. Urban facilitiesPrivate pharmacyHospital*Private GPBLRP Ceph ESP Flquin Macro Cotrim Tetra% prescriptions with ABM100806040200A2. Urban facilitiesPrivate pharmacyHospital*Private GPBLRP Ceph ESP Flquin Macro Cotrim Tetra% prescriptions with ABM100806040200B1. Rural facilitiesPrivate pharmacyHospital*Private GPBLRP Ceph ESP Flquin Macro Cotrim Tetra% prescriptions with ABM100806040200B2. Rural facilitiesPrivate phamacyHospital*Private GPBLRP Ceph ESP Flquin Macro Cotrim Tetra* Not‐for‐profit and for‐profit hospitals in the urban area; public sector primary health care clinics and a notfor‐profithospital in the rural area36
Page 2 and 3: WHO/EMP/MAR/2009.2Community-Based S
Page 4 and 5: CONTENTSProject members ...........
Page 6: 8.4 Lessons learnt concerning imple
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Page 14 and 15: How this report is organizedHow thi
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