ArticlePloS one2016
Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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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
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Public target interventions to reduce the inappropriate use of medicines or medical procedures: a systematic review.Implementation science : IS · 2020Pooled it
- Impact of national interventions to promote responsible antibiotic use: a systematic review.The Journal of antimicrobial chemotherapy · 2020Pooled it
- Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map.PLoS medicine · 2019Pooled it
- Epidemiological characteristics of antimicrobial use in Primary Care in Spain: a nationwide study.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Observational
- An Evaluation of the Impact of an OPEN Stewardship Generated Feedback Intervention on Antibiotic Prescribing among Primary Care Veterinarians in Canada and Israel.Animals : an open access journal from MDPI · 2024Article
- An insights into emerging trends to control the threats of antimicrobial resistance (AMR): an address to public health risks.Archives of microbiology · 2024Review
- Relation of poverty with treatment-seeking behavior and antibiotic misuse among UTI patients in Pakistan.Frontiers in public health · 2024Article
- Analyzing the relationship between socioeconomic deprivation and outpatient Medicare Part D fluoroquinolone claim rates in Texas.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Socio-economic, governance and health indicators shaping antimicrobial resistance: an ecological analysis of 30 european countries.Globalization and health · 2023Article
- Country data on AMR in Brazil in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome.The Journal of antimicrobial chemotherapy · 2022Article
- Country data on AMR in Pakistan in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome.The Journal of antimicrobial chemotherapy · 2022Article
- Examining the association between socio-demographic factors, catheter use and antibiotic prescribing in Northern Ireland primary care: a cross-sectional multilevel analysis.Epidemiology and infection · 2022Article
- Determinants of Antimicrobial Resistance among the Different European Countries: More than Human and Animal Antimicrobial Consumption.Antibiotics (Basel, Switzerland) · 2021Article
- Article
- Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006-2017.International journal of environmental research and public health · 2020Article
- Socioeconomic factors associated with antimicrobial resistance ofRevista panamericana de salud publica = Pan American journal of public health · 2020Article
- Socioeconomic Enablers for Contagion: Factors Impelling the Antimicrobial Resistance Epidemic.Antibiotics (Basel, Switzerland) · 2019Article
- Deterministic processes structure bacterial genetic communities across an urban landscape.Nature communications · 2019Article
- Extended-spectrum β-lactamase, plasmid-mediated AmpC β-lactamase, fluoroquinolone resistance, and decreased susceptibility to carbapenems inAntimicrobial resistance and infection control · 2019Article
- Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundImproper antibiotic use is one of the main drivers of bacterial resistance to antibiotics, increasing infectious diseases morbidity and mortality and raising costs of healthcare. The level of antibiotic consumption has been shown to vary according to socioeconomic determinants (SED) such as income and access to education. In many Latin American countries, antibiotics could be easily purchased without a medical prescription in private pharmacies before enforcement of restrictions on over-the-counter (OTC) sales in recent years. Brazil issued a law abolishing OTC sales in October 2010. This study seeks to find SED of antibiotic consumption in the Brazilian state of São Paulo (SSP) and to estimate the impact of the 2010 law.
methodsData on all oral antibiotic sales having occurred in the private sector in SSP from 2008 to 2012 were pooled into the 645 municipalities of SSP. Linear regression was performed to estimate consumption levels that would have occurred in 2011 and 2012 if no law regulating OTC sales had been issued in 2010. These values were compared to actual observed levels, estimating the effect of this law. Linear regression was performed to find association of antibiotic consumption levels and of a greater effect of the law with municipality level data on SED obtained from a nationwide census.
resultsOral antibiotic consumption in SSP rose from 8.44 defined daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010, and fell to 8.06 DID in 2012. Determinants of a higher consumption were higher human development index, percentage of urban population, density of private health establishments, life expectancy and percentage of females; lower illiteracy levels and lower percentage of population between 5 and 15 years old. A higher percentage of females was associated with a stronger effect of the law.
conclusionsSSP had similar antibiotic consumption levels as the whole country of Brazil, and they were effectively reduced by the policy.
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Registered trials
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