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Open AccessArticle

Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India

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Department of Public Health Sciences, Global Health—Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Tomtebodavagen 18A, SE-171 77 Stockholm, Sweden
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Department of Public Health and Environment, RD Gardi Medical College, Ujjain, Madhya Pradesh 456006, India
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Department of Pathology, RD Gardi Medical College, Ujjain, Madhya Pradesh 456006, India
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Department of Pharmacology, RD Gardi Medical College, Ujjain, Madhya Pradesh 456006, India
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Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, RD Gardi Medical College, Ujjain, Madhya Pradesh 456006, India
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International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain, Madhya Pradesh 456001, India
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Department of Pediatrics, RD Gardi Medical College, Ujjain, Madhya Pradesh 456006, India
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Department of Women and Children’s Health, International Maternal and Child Health Unit, Uppsala University, SE-751 85 Uppsala, Sweden
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Author to whom correspondence should be addressed.
Antibiotics 2019, 8(3), 139; https://doi.org/10.3390/antibiotics8030139
Received: 9 August 2019 / Revised: 31 August 2019 / Accepted: 3 September 2019 / Published: 5 September 2019
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
Informal healthcare providers (IHCPs) are predominant healthcare providers in rural India, who prescribe without formal training. Antibiotic prescription by IHCPs could provide crucial information for controlling antibiotic resistance. The aim of this study is to determine the practices and seasonal changes in antibiotic prescribing for common illnesses by IHCPs. A repeated cross-sectional study was conducted over 18 months, covering different seasons in the rural demographic surveillance site, at Ujjain, India. Prescriptions given to outpatients by 12 IHCPs were collected. In total, 15,322 prescriptions for 323 different complaint combinations were analyzed, of which 11,336 (74%) included antibiotics. The results showed that 14,620 (95%) of antibiotics prescribed were broad spectrum and the most commonly prescribed were fluoroquinolones (4771,31%), followed by penicillin with an extended spectrum (4119,27%) and third-generation cephalosporin (3069,20%). Antibiotics were prescribed more frequently in oral and dental problems (1126,88%), fever (3569,87%), and upper respiratory tract infections (3273, 81%); more during the monsoon season (2350,76%); and more frequently to children (3340,81%) than to adults (7996,71%). The study concludes that antibiotics were the more commonly prescribed drugs compared to other medications for common illnesses, most of which are broad-spectrum antibiotics, a situation that warrants further investigations followed by immediate and coordinated efforts to reduce unnecessary antibiotic prescriptions by IHCPs. View Full-Text
Keywords: Healthcare providers; prescription; antibiotics; infectious diseases; rural population; India Healthcare providers; prescription; antibiotics; infectious diseases; rural population; India
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Khare, S.; Purohit, M.; Sharma, M.; Tamhankar, A.J.; Lundborg, C.S.; Diwan, V.; Pathak, A. Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India. Antibiotics 2019, 8, 139.

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