Abstract
BackgroundIn Latin American countries over-the-counter (OTC) dispensing of antibiotics is common. In 2010, both Mexico and Brazil implemented policies to enforce existing laws of restricting consumption of antibiotics only to patients presenting a prescription. The objective of the present study is therefore to evaluate the impact of OTC restrictions (2010) on antibiotics consumption in Brazil and Mexico.Methods and FindingsRetail quarterly sales data in kilograms of oral and injectable antibiotics between January 2007 and June 2012 for Brazil and Mexico were obtained from IMS Health. The unit of analysis for antibiotics consumption was the defined daily dose per 1,000 inhabitants per day (DDD/TID) according to the WHO ATC classification system. Interrupted time series analysis was conducted using antihypertensives as reference group to account for changes occurring independently of the OTC restrictions directed at antibiotics. To reduce the effect of (a) seasonality and (b) autocorrelation, dummy variables and Prais-Winsten regression were used respectively.Between 2007 and 2012 total antibiotic usage increased in Brazil (from 5.7 to 8.5 DDD/TID, +49.3%) and decreased in Mexico (10.5 to 7.5 DDD/TID, −29.2%). Interrupted time series analysis showed a change in level of consumption of −1.35 DDD/TID (p<0.01) for Brazil and −1.17 DDD/TID (p<0.00) for Mexico. In Brazil the penicillins, sulfonamides and macrolides consumption had a decrease in level after the intervention of 0.64 DDD/TID (p = 0.02), 0.41 (p = 0.02) and 0.47 (p = 0.01) respectively. While in Mexico it was found that only penicillins and sulfonamides had significant changes in level of −0.86 DDD/TID (p<0.00) and −0.17 DDD/TID (p = 0.07).ConclusionsDespite different overall usage patterns of antibiotics in Brazil and Mexico, the effect of the OTC restrictions on antibiotics usage was similar. In Brazil the trend of increased usage of antibiotics was tempered after the OTC restrictions; in Mexico the trend of decreased usage was boosted.
Highlights
Inappropriate use of antibiotics enhances the development of antibacterial resistance, which is an important public health issue
In Brazil the trend of increased usage of antibiotics was tempered after the OTC restrictions; in Mexico the trend of decreased usage was boosted
For Brazil we indicated the beginning of the regulated consumption at the first quarter of 2011 since the startup of the banning of OTC of antibiotics sales was on November 29th of 2010; while for Mexico we considered the beginning of the regulated consumption at the last quarter of 2010, since the regulation took place from August 25th of the same year
Summary
Inappropriate use of antibiotics enhances the development of antibacterial resistance, which is an important public health issue. In 2005, Colombia started to regulate the OTC sales of antibiotics only in the capital city Bogota, while in Venezuela at the beginning of 2006, a similar policy was implemented but only applied to three therapeutic groups: macrolides, quinolones and third generation cephalosporins. The effect of these policies were evaluated recently, showing a decrease in level of consumption in Colombia, but no change in level or trend in Venezuela [6]. Two of the largest countries in Latin America, Brazil and Mexico, implemented a similar policy during 2010 enforcing the prohibition of all systemic antibiotic sales without prescription. The objective of the present study is to evaluate the impact of OTC restrictions (2010) on antibiotics consumption in Brazil and Mexico
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
