Evidence map›Paper›PMID 34932455›Full record

ArticleEmerging infectious diseases2022

Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, São Paulo, Brazil.

Maria L Moura, Icaro Boszczowski, Manuela Blaque, Rafael M Mussarelli, Victor Fossaluza, Ligia C Pierrotti, Gustavo Campana, Maria C Brandileone, Rosemeire Zanella, Samanta C G Almeida and 1 more

Open access · diamondAbstract read
In one paragraph

Article in Emerging infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 21% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. The Crisis of Macrolide Resistance in Pneumococci in Latin America.The American journal of tropical medicine and hygiene · 2024
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Maria L Moura
Icaro Boszczowski
Manuela Blaque
Rafael M Mussarelli
Victor Fossaluza
Ligia C Pierrotti
Gustavo Campana
Maria C Brandileone
Rosemeire Zanella
Samanta C G Almeida
Anna S Levin
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRMeningitis Now · GBDASA (Brazil)Instituto do Sono · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although restricting over-the-counter (OTC) antimicrobial drug sales is recommended globally, no data track its effect on antimicrobial resistance (AMR) in bacteria. We evaluated the effect of a national policy restricting OTC antimicrobial sales, put in place in November 2010, on AMR in a metropolitan region of São Paulo, Brazil. We reviewed associations between antimicrobial sales from private pharmacies and AMR in 404,558 Escherichia coli and 5,797 Streptococcus pneumoniae isolates using a dynamic regression model based on a Bayesian approach. After policy implementation, a substantial drop in AMR in both bacterial species followed decreased amoxicillin and trimethoprim/sulfamethoxazole sales. Conversely, increased ciprofloxacin sales were associated with increased ciprofloxacin resistance, and extended spectrum β-lactamases-positive E. coli isolates and azithromycin sales increases after 2013 were associated with increased erythromycin resistance in S. pneumoniae isolates. These findings suggest that restricting OTC antimicrobial sales may influence patterns of AMR, but multifaceted approaches are needed to avoid unintended consequences.

Indexed as

Anti-Bacterial AgentsAnti-Infective AgentsBayes TheoremBrazilDrug Resistance, BacterialEscherichia coliMicrobial Sensitivity TestsPolicyAnti-Bacterial AgentsAnti-Infective Agentsanti-infective agentsantimicrobial drugsantimicrobial resistancebacteriaBrazilgovernment regulationnonprescription drugsover-the-counter drugspublic healthpublic policy

Identifiers

PMID34932455
PMCPMC8714220
OpenAlexW4200201333

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.