Effects of intervention measures on irrational antibiotics/antibacterial drug use in developing countries

Abstract

is a global problem, especially in developing countries. This results in an increased emer-gence of resistance to most common bacteria, higher cost of treatment, prolonged hospitaliza-tion and adverse drug reactions. Interventions measures have been instituted to avert the problem but it still persists. A systematic review was conducted to determine the effect of dif-ferent interventions (education, managerial, di-agnostic tests, regulatory, economic and multi-faceted) on misuse of AB drugs in developing countries. A total of 722 articles were retrieved and 55 were reviewed. About 10.9% of the stu-dies were from Africa, 63.6% from Asia, 9.1% from Latin America, and 16.4% from Southeas-tern Europe. A total of 52.7% of the studies were from hospital settings, 5.5% from outpatient departments, 21.8% were from public health care facilities, 12.7% from private pharmacies/drug stores, and 7.3% from the communities. Educa-tion intervention had 27.3% studies, managerial had 20%, managerial/education had 3.6%, regu-latory had 9.1%, education/regulation had 9.1% and diagnostic had 3.6% studies. Multifaceted intervention had 27.3% studies, with 63% im-provement in appropriate AB doses prescribed, 2.6% mean number of AB encounter reduction, 23% AB prescription reduction, 18.3% generic AB prescription improvement, 32.1% reduction in AB use, 89% reduction in AB use in acute respiratory infection, 82% in surgery, 62.7% mean reduction in deliveries, 39% in STDs, 36.3% mean reduction in diarrhea, 14.6% mean reduc-tion AB use in malaria, and 6% - 11% in the cost of treating bacteria-resistant organisms. Also noted was 6.3% reductions in mean AB en-counters after 1 month of intervention, and then increased to 7.7% after 3 months thus lacking sustainability. Multifaceted interventions were ef- fective in reducing irrational AB drug use in the various health facilities and communities as well as reduction in the emergence of resistance to the commonest bacteria in the developing coun- tries though there was lack of sustainability or continuity of rational drug use over the time.