Community-Based Surveillance of Antimicrobial Use and ...

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6. Durban, South AfricaTable 6.4: Annual use of ABM measured as percentage of prescriptions with specific ABM:February 2003 to January 200415Private pharmacyPublic PHCDispensing practitioner*% prescriptions with ABM1050Pen Cotrim Ceph Macro Tetra FlquinTable 6.5: Annual use of specific ABM measured as number of DDDs per 100 patients:February 2003 to January 2004No.DDDs ABM / 100 patients70605040302010Private PharmacyPublic PHCDispensing Practitioner*0Pen Cotrim Ceph Macro Tetra Flquin* Private facilityThe use of both measures did allow for differences in practice to become apparent. Forexample, while the percentage of prescriptions containing a fluoroquinolone was higher inthe PHC clinics compared to the pharmacies, total exposure measured as DDD per 100patients was higher in pharmacies. The likely reason is that ciprofloxacin was, at that time,included as a single dose in the syndromic management protocols for certain sexuallytransmitted diseases, which were applied in the public sector PHC clinics.6.3.2.3 Trends in specific ABM use over timeMonthly trends in the use of different ABMs per facility types are shown, using bothmeasures, in Figure 6.6. Some evidence of an increase in cotrimoxazole use in PHC clinicscould be seen towards the end of the study period, perhaps linked to the introduction of a75
Community-based surveillance of antimicrobial useand resistance in resource-constrained settingsprophylaxis policy for Pneumocystis jiroveci in HIV‐positive patients in the public sector. Asindividual patients would receive doses sufficient for use for a month, this would bereflected in the total DDDs prescribed.Table 6.6 (A-D): Monthly use of specific ABM from February 2003 to January 2004Percentage of prescriptions containing specific ABMNumber of DDDs of specific ABM per 100 patientsA1. CotrimoxazoleA2. Cotrimoxazole% prescriptions with ABM20151050Private pharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec JanNo.DDDs ABM / 100 patients100806040200Private PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan% prescriptions with ABM20151050B1. PenicillinsPrivate PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec JanNo.DDDs ABM / 100 patients100806040200B2. PenicillinsPrivate PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec JanC1. QuinolonesC2. Quinolones% prescriptions with ABM20151050Private PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec JanNo.DDDs ABM / 100 patients100806040200Private PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan% prescriptions with ABM20151050D1. TetracyclinesPrivate PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec JanNo.DDDs ABM / 100 patients100806040200D2. TetracyclinesPrivate PharmacyPublic PHCDispensing practitioner*AverageFeb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan* Private facility6.3.3 Effect of ABM on AMRIt was not expected that ABM use would be associated with any AMR changes over theperiod of the pilot study. Although based on scanty data, it was notable that AMR tocotrimoxazole appears to be high among both H. influenzae and S. pneumoniae isolates.76
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WHO/EMP/MAR/2009.2Community-Based S
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CONTENTSProject members ...........
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8.4 Lessons learnt concerning imple
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Community-based surveillance of ant
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How this report is organizedHow thi
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Executive summaryExecutive summaryI
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Executive summaryAlthough ABM use a
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1. Background, aims and general met
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