ReviewUpsala journal of medical sciences2014
Access, excess, and ethics--towards a sustainable distribution model for antibiotics.
Review in Upsala journal of medical sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Physicians', pharmacists', and nurses' education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review.Frontiers in antibiotics · 2024Pooled it
- Assessing the impact of law enforcement to reduce over-the-counter (OTC) sales of antibiotics in low- and middle-income countries; a systematic literature review.BMC health services research · 2019Pooled it
- Responding to and managing antibiotic shortages: a qualitative study with experts and opinion leaders.Wellcome open research · 2025Article
- Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence.JAC-antimicrobial resistance · 2024Review
- Antimicrobial stewardship: a definition with a One Health perspective.npj antimicrobials and resistance · 2024Review
- Article
- Antimicrobial Resistance Policy Protagonists and Processes-A Qualitative Study of Policy Advocacy and Implementation.Antibiotics (Basel, Switzerland) · 2022Article
- The New Precision Stewards?Journal of personalized medicine · 2022Article
- Ethics and antibiotic resistance.British medical bulletin · 2022Article
- Antibiotic Stewardship in Retail Pharmacies and the Access-Excess Challenge in China: A Policy Review.Antibiotics (Basel, Switzerland) · 2022Review
- Mapping the Antimicrobial Supply Chain in Bangladesh: A Scoping-Review-Based Ecological Assessment Approach.Global health, science and practice · 2021Article
- An Effort Worth Making: A Qualitative Study of How Swedes Respond to Antibiotic Resistance.Public health ethics · 2021Article
- Combatting antimicrobial resistance globally.Nature microbiology · 2016Article
- Antimicrobial resistance-a threat to the world's sustainable development.Upsala journal of medical sciences · 2016Review
- Towards the just and sustainable use of antibiotics.Journal of pharmaceutical policy and practice · 2016Review
- The Ethical Significance of Antimicrobial Resistance.Public health ethics · 2015Article
- High prevalence of antibiotic resistance in nasopharyngeal bacterial isolates from healthy children in rural Uganda: A cross-sectional study.Upsala journal of medical sciences · 2015Article
- Securing access to effective antibiotics for current and future generations. Whose responsibility?Upsala journal of medical sciences · 2014Article
- Antibiotic Resistance, Still a Global Challenge.Current health sciences journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The increasing antibiotic resistance is a global threat to health care as we know it. Yet there is no model of distribution ready for a new antibiotic that balances access against excessive or inappropriate use in rural settings in low- and middle-income countries (LMICs) where the burden of communicable diseases is high and access to quality health care is low. Departing from a hypothetical scenario of rising antibiotic resistance among pneumococci, 11 stakeholders in the health systems of various LMICs were interviewed one-on-one to give their view on how a new effective antibiotic should be distributed to balance access against the risk of inappropriate use. Transcripts were subjected to qualitative 'framework' analysis. The analysis resulted in four main themes: Barriers to rational access to antibiotics; balancing access and excess; learning from other communicable diseases; and a system-wide intervention. The tension between access to antibiotics and rational use stems from shortcomings found in the health systems of LMICs. Constructing a sustainable yet accessible model of antibiotic distribution for LMICs is a task of health system-wide proportions, which is why we strongly suggest using systems thinking in future research on this issue.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.