Overuse Of Antibiotics Research Articles

PREVALENCE OF SELF-MEDICATION PRACTICE AMONG THE PEOPLE IN NANGARHAR, AFGHANISTAN

Self-medication, the practice of using medication without medical supervision, is widespread in many low-income settings, including Afghanistan, where access to healthcare services can be limited. Despite its convenience, self-medication carries significant risks, such as drug resistance and adverse reactions, particularly with the misuse of antibiotics and other prescription medications. Objective: This study aimed to assess the prevalence and factors influencing self-medication practices among residents of Nangarhar, Afghanistan, focusing on common illnesses and types of medications used. Methods: A cross-sectional survey was conducted between January and June 2024 among 1,020 individuals, both male and female, aged 18 years and above, across Nangarhar. Participants were selected through random sampling. Data collection was performed using structured questionnaires, which gathered information on demographics, types of illnesses, medications used, and factors influencing self-medication practices. Descriptive and inferential statistical analyses were performed using SPSS software. Results: Of the total respondents, 62.6% reported self-medicating in the past six months. The most commonly reported ailments leading to self-medication were pain relief (45.2%), fever (39.8%), headache (38.7%), and gastrointestinal issues (27.5%). Antibiotics (46.1%) and analgesics (43.3%) were the most frequently used medications without prescriptions. Key reasons for self-medication included easy access to pharmacies (64.7%), high costs of healthcare (57.2%), and previous experiences with similar symptoms (49.8%). Lack of awareness about the dangers of self-medication and a perceived lack of severity of symptoms were also major contributing factors. Conclusion: Self-medication is a prevalent practice among residents of Nangarhar, Afghanistan, driven largely by ease of access to medications, economic barriers to healthcare, and low health literacy. Public health interventions, including educational campaigns and stricter regulations on over-the-counter medication sales, are urgently needed to mitigate the potential risks associated with this practice.

Proof of concept study on early forecasting of antimicrobial resistance in hospitalized patients using machine learning and simple bacterial ecology data.

Antibiotic resistance in bacterial pathogens is a major threat to global health, exacerbated by the misuse of antibiotics. In hospital practice, results of bacterial cultures and antibiograms can take several days. Meanwhile, prescribing an empirical antimicrobial treatment is challenging, as clinicians must balance the antibiotic spectrum against the expected probability of susceptibility. We present here a proof of concept study of a machine learning-based system that predicts the probability of antimicrobial susceptibility and explains the contribution of the different cofactors in hospitalized patients, at four different stages prior to the antibiogram (sampling, direct examination, positive culture, and species identification), using only historical bacterial ecology data that can be easily collected from any laboratory information system (LIS) without GDPR restrictions once the data have been anonymised. A comparative analysis of different state-of-the-art machine learning and probabilistic methods was performed using 44,026 instances over 7 years from the Hôpital Européen Marseille, France. Our results show that multilayer dense neural networks and Bayesian models are suitable for early prediction of antibiotic susceptibility, with AUROCs reaching 0.88 at the positive culture stage and 0.92 at the species identification stage, and even 0.82 and 0.92, respectively, for the least frequent situations. Perspectives and potential clinical applications of the system are discussed.

Impact of antibiotic changes on hospital stay and treatment duration in community-acquired pneumonia.

The misuse and overtreatment of antibiotics in hospitalized patients with community-acquired pneumonia (CAP) can cause multi-drug resistance and worsen clinical outcomes. We aimed to analyze the trends and appropriateness of antibiotic changes in hospitalized patients with CAP and their impact on clinical outcomes. This retrospective study enrolled patients with CAP, aged > 18 years, admitted from January 2017 to December 2021 at Seoul National University Bundang Hospital, South Korea. We examined the pathogens identified, antibiotics prescribed, and the appropriateness of antibiotic changes as reviewed by infectious disease specialists. Antibiotic appropriateness was assessed based on adherence to the 2019 ATS/IDSA guidelines and the 2018 Korean national guidelines for CAP, targeting appropriate pathogens, proper route, dosage, and duration of therapy. Outcomes measured included time to clinical stability (TCS), length of hospital stay, duration of antibiotic treatment, and in-hospital mortality. The study included 436 patients with a mean age of 72.11 years, of whom 35.1% were male. The average duration of antibiotic treatment was 13.5 days. More than 55% of patients experienced at least one antibiotic change, and 21.7% had consecutive changes. Throughout their hospital stay, 273 patients (62.6%) received appropriate antibiotic treatment, while 163 patients (37.4%) received at least one inappropriate antibiotic prescription. Those who received at least one inappropriate prescription experienced longer antibiotic treatment durations and extended hospital stays, despite having similar TCS. In conclusion, inappropriate antibiotic prescribing in hospitalized patients with CAP is associated with prolonged antibiotic treatment and increased length of stay. Emphasizing the appropriate initial antibiotic selection may help mitigate these negative effects.

Appropriateness of antibiotic prescribing among patients treated for dental diseases in Mekelle city, Northern Ethiopia: a cross sectional study

BackgroundLocal operative treatments are generally preferred for most dental diseases, with antibiotics only recommended as an adjunct in specific cases. Misuse and overuse of antibiotics has been shown to significantly contribute to the development of resistant bacteria. However, the antibiotic prescribing practices of dentists in Ethiopia have not been thoroughly studied. This study aimed to assess the appropriateness of antibiotic prescribing for patients with dental diseases at dental clinics in Mekelle City, Northern Ethiopia.MethodsA cross sectional study was conducted in April and May 2020 among patients visiting dental clinics in Mekelle City. Data were collected through patient medical record reviews and dentist interviews. The appropriateness of antibiotic prescription was evaluated based on guidelines from the American Dental Association and the European Society of Endodontology. Data were analyzed using SPSS Statistics, version 29. Binary logistic regression analysis was performed, and the results were presented as odds ratios with 95% confidence intervals. A p value less than 0.05 was considered statistically significant.ResultsTwo hundred and thirty-one patients with dental diseases participated in the study. The mean age was 30.6 years with a standard deviation of 16.1. Most participants had dental pulp related disease. 89% of patients were prescribed antibiotics, with amoxicillin being the most common. Inappropriate antibiotic prescribing was identified in 175 (75.8%) of the study participants. The most common inappropriate prescribing was unnecessary antibiotic prescribing for dental conditions without systemic signs, assessed in 141 (80.1%) participants. Patients diagnosed with pulp related disease without systemic signs and those who had tooth extractions were significantly associated with inappropriate antibiotic prescription (p value < 0.001).ConclusionsThe study findings show that antibiotics are over-prescribed for dental conditions in this resource constrained setting, especially in patients who have had tooth extractions. Dentists need training on appropriate antibiotic use and antimicrobial stewardship interventions should be implemented in dental setting to reduce unnecessary antibiotic prescriptions and prevent antibiotic resistance development.

Public health implications of antibiotic resistance in sewage water: an epidemiological perspective

The emergence and rapid spread of antibiotic resistance pose a major threat to global health, attributing to misuse and overuse of antibiotics resulting in antibiotics-resistant bacteria through natural mutation or transfer of resistance genes. A cross-sectional study was carried out, in which a total of 36 samples were systematically collected; of these, 26 were derived from the wastewater efflux and 10 from the receiving waters at several critical junctures along the Sutlej River. Herein, this study elucidated elevated levels of antibiotic resistance among bacterial isolates sourced from urban wastewater. Escherichia coli (E. coli) was the highest at 90% among the isolates, followed by Klebsiella pneumoniae (K. pneumoniae) at 58%, Pseudomonas aeruginosa (P. aeruginosa) at 55%, and Salmonella spp. at 53%. Many antibiotics were found to be more resistant including Ciproflaxacin, Co-Trimaxazole, Ampicillin and Tetracycline. Several antibiotic-resistance genes were found in isolated bacterial spp., such as Aminoglycosides (aadA), Sulfonamides (Sul1, Sul3), Tetracyclines (Tet (A/B/D)) and Cephalosporins (Bla_CTM X) at 41%, 35%, 29% and 12% respectively. Furthermore, the development of innovative wastewater treatment models and surveillance programs are crucial to counteract the dissemination of antibiotic resistance. To investigate the genetic determinants of antibiotic resistance, molecular analysis was performed, including DNA isolation, PCR amplification, and sequence analysis. The study helps investigate a diverse range of ARBs and ARGs in wastewater, which highlights the need of better laws for antibiotic usage and wastewater treatment processes. This investigation also stresses on regular monitoring of ARBs and ARGs in sewage wastewater. Through proactive interventions and sustained scientific inquiry, we can strive toward preserving environmental integrity and public health for successive generations.Graphical

Primary Healthcare Physicians' Insufficient Knowledge Is Associated with Antibiotic Overprescribing for Acute Upper Respiratory Tract Infections in China: A Cross-Sectional Study.

Overuse of antibiotics in healthcare remains prevalent and requires urgent attention in China, particularly in primary healthcare (PHC) facilities. This study aimed to describe the patterns of antibiotic prescriptions for acute upper respiratory tract infections (URTIs) in PHC facilities in China and to investigate how PHC physicians' knowledge influences their antibiotic prescribing behavior. A cross-sectional survey linking physician questionnaire responses and their prescription data was conducted in Shaanxi Province, China. The proportions of URTI visits that received at least one antibiotic, combined antibiotics, and broad-spectrum antibiotics were the main outcomes reflecting antibiotic prescribing behavior. Multivariate mixed-effects logistic regressions were applied to analyze the relationship between PHC physicians' knowledge about antibiotics and their antibiotic prescribing behavior. A total of 108 physicians filled out the questionnaires between February 2021 and July 2021, and a sample of 11,217 URTI visits attended by these physicians from 1 January 2020 to 31 December 2020 were included in the analysis. The overall mean score of our respondents on the knowledge questions was 5.2 (total score of 10). Over sixty percent (61.2%; IQR 50.2-72.1) of the URTI visits received antibiotics. The percentages of URTI visits prescribed with combined and broad-spectrum antibiotics were 7.8% (IQR 2.3-10.2) and 48.3% (IQR 36.7-58.7), respectively. Third-generation cephalosporins were the most frequently used antibiotics. Physicians with lower antibiotic knowledge scores were more inclined to prescribe antibiotics (p < 0.001), combined antibiotics (p = 0.001), and broad-spectrum antibiotics (p < 0.001). Physicians' insufficient knowledge was significantly associated with antibiotic overprescribing. Professional training targeting physicians' knowledge of antibiotics is urgently needed to improve the rational use of antibiotics in grassroots healthcare facilities in China.

Misuse of Antibiotics in Pediatric Patients – A Comprehensive Review .

To identify and assess the likely causes of antibiotic overuse in the Pediatric outpatient department (OPD) of a busy teaching hospital. Overuse of antibiotics has emerged as a significant global pediatric concern. Specifically, the sale of drugs without a prescription from a doctor and other circumstances may have an impact on the abuse of antibiotics. Antibiotic resistance is encouraged by the misuse of antibiotics, particularly when antibiotics are used, even when they are not the recommended course of therapy. The Centers for Disease Control and Prevention estimate that between one-third and half of all antibiotic usage in humans is unwarranted or improper. Viral pathogens are the primary cause of respiratory tract infections (RTI) in children compared to adults. Interestingly, compared to adults with RTI, very little is known regarding the usage of antibiotics in children.

The Impact of Antibiotic Misuse in Adult Patients: A Review of Contributing Factors, Consequences, and Strategies for Mitigation.

Antibiotic misuse, characterized by inappropriate use, over-prescription, and self-medication, is a severe threat to health in that it increases the rate at which antibiotic-resistant bacteria develop. This paper provides a review of antibiotic misuse concerning adult patients, an outline of factors that perpetuate it, the consequences, and the possible mitigation strategies. We discuss patient-related issues, such as lack of knowledge and non-compliance, problems with healthcare providers in terms of over-subscription and poor training, and system problems like poor stewardship programs and lack of regulatory efforts. In addition, the authors debate the environmental consequences of poor antibiotic stewardship coming from agriculture use and contamination. The consequences of misuse include the development of antibiotic-resistant pathogens and deleterious drug reactions, but also imply significant costs to the health system. The review calls for increased antibiotic stewardship, improved patient education, the development of new antimicrobial agents, and good policy infection control. This review is essence, a call to multifaceted efforts in the fight against the misuse of antibiotics and stresses that continuous research works are required to change policies. Antibiotic misuse is emerging as a global problem because addressing this problem not only ensures sustainability in the existing antibiotics but also assures that public health is protected.

High-performance ratiometric fluorescence detection and removal of tetracycline in milk based on CDs@ZSM-5:Eu3+

Exploring materials with the dual functionality of detecting and removing tetracycline (TC) residues is crucial because of the environmental and health risks posed by antibiotic overuse. This study introduces a dual-emissive luminescent probe, CDs@ZSM-5:Eu3+, created through a solvent-free method combined with subsequent Eu3+ion exchange. The nanocomposite's blue emission, originating from carbon dots (CDs), is quenched by TC via an internal filtering effect, while an antenna effect triggers a strong red fluorescence of a TC-Eu3+chelate. The ratiometric fluorescence changes in CDs@ZSM-5:Eu3+ endow a self-calibrated sensing mechanism for TC, offering a low detection limit of 5.04 nM and a broad detection range of 0.01–50 μM. Demonstrated in real milk samples, the probe exhibits high selectivity and accuracy in detecting TC. The nanocomposite also displayed an impressive TC removal capacity of 238.1 mg g−1 in water, ascribing to the enrichment and electrostatic attraction effects of ZSM-5 toward TC molecules. This research offers a facile strategy for constructing multifunctional zeolite-based hybrids for simultaneous TC detection and removal from aqueous solutions.

Efficient control of antibiotic resistance in wastewater by UV/peracetic acid treatment: Unveiling distinct mechanisms behind the elimination of various contaminants

The abuse of antibiotics has led to an increase in contamination by antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) in the environment, especially in wastewater treatment plants, which are the main treatment sites for antibiotic contaminants. In this study, we demonstrated that the combined ultraviolet (UV)/peracetic acid (PAA) process effectively removes coexisting antibiotics, ARB, and ARGs simultaneously by removing 96 % of ampicillin (AMP, with an initial concentration of 10 μM) in 8 min and completely inactivating super-resistant Escherichia coli (E. coli) NDM-1 (i.e., achieving 7.44-log reduction) in just 3 min (PBS, pH=7.0). These bacteria did not proliferate during the 86-h bacterial regrowth test. The analysis of radical quenching and electron paramagnetic resonance revealed that reactive species, such as hydroxyl radicals (·OH) and carbon-centered organic radicals (R-C·), played dominant roles in AMP removal, whereas UV irradiation was crucial for ARB inactivation. Furthermore, the ARGs fragments were efficiently damaged, as demonstrated by gel electrophoresis analysis, leaving few intact sequences. This strategy effectively reduced the horizontal transfer frequency of ARGs. Subsequent evaluations of the stability and efficiency of UV/PAA for pollutant removal in real wastewater further affirmed the broad applicability of the UV/PAA process. This study revealed that UV/PAA system has the potential to alleviate the burden of antibiotic resistance and contribute to a better comprehension and application for novel technology to control antibiotic resistance spread.

Prediction of Antibiotic Susceptibility in E. coli Isolates Using Machine Learning.

Antimicrobial resistance (AMR) poses a significant global health threat, resulting in 4.96 million deaths in 2019, with projections reaching 10 million by 2050. This resistance, primarily due to the overuse of antibiotics, complicates the treatment of infections caused by various microorganisms, including the gram-negative bacterium Escherichia coli. Traditional culture-based methods for detecting AMR are slow and imprecise, hindering timely clinical decision-making. In contrast, whole genome sequencing offers a faster, more accurate alternative for AMR detection. A novel machine learning study leveraging whole genomic sequencing data to predict the phenotypic susceptibility of Escherichia coli to ciprofloxacin is presented. Using a novel dataset of 256 bacterial genomes and related susceptibility data, features were generated based on AMRFinderPlus findings and k-mer frequencies. The machine learning models, Random Forest and XGBoost, were evaluated using a five-fold cross-validation approach. Results showed that combining AMRFinderPlus and k-mer frequency features could achieve more than 90% accuracy using the XGBoost gradient boosting model. These findings suggest that the best results may be achieved using reference-free features combined with known gene markers.

Diagnosis and treatment of community-acquired pneumonia in children

Community-acquired pneumonia (CAP) is one of the most common diseases in children. In recent years, the use of conjugate vaccines has significantly reduced the burden of the main pathogens, Streptococcus pneumoniae and Haemophilus influenzae type B. To date, viruses are the most frequently detected causative agents of CAP in children. New knowledge about the etiology and treatment of CAP in children gained in recent years has influenced the management, and this was the purpose of this work. In addition to reducing diagnostic uncertainty, there is a need to reduce antibiotic overuse and antimicrobialresistance in children with CAP.

Progress in antibacterial applications of nanozymes.

Bacterial infections are a growing problem, and antibiotic drugs can be widely used to fight bacterial infections. However, the overuse of antibiotics and the evolution of bacteria have led to the emergence of drug-resistant bacteria, severely reducing the effectiveness of treatment. Therefore, it is very important to develop new effective antibacterial strategies to fight multi-drug resistant bacteria. Nanozyme is a kind of enzyme-like catalytic nanomaterials with unique physical and chemical properties, high stability, structural diversity, adjustable catalytic activity, low cost, easy storage and so on. In addition, nanozymes also have excellent broad-spectrum antibacterial properties and good biocompatibility, showing broad application prospects in the field of antibacterial. In this paper, we reviewed the research progress of antibacterial application of nanozymes. At first, the antibacterial mechanism of nanozymes was summarized, and then the application of nanozymes in antibacterial was introduced. Finally, the challenges of the application of antibacterial nanozymes were discussed, and the development prospect of antibacterial nanozymes was clarified.

Cu2O-SnO2-PDA heterozygous nanozyme doped hydrogel mediated conglutinant microenvironment regulation for wound healing therapy

Bacterial infection significantly hinders the wound healing process. Overuse of antibiotics has led to the rise of drug resistance in bacteria, making the development of smart medical dressings that promote wound healing without antibiotics, a critical need. In this study, Cu₂O-SnO₂-PDA (PCS) nanoenzymes with Fenton-like activity and high photothermal conversion efficiency were developed. These nanoenzymes were then incorporated into a hydrogel through cross-linking of acrylamide (AM) and N-[Tris-(hydroxymethyl)methyl] acrylamide (THMA), forming a tough, highly-adhesive, and self-healing composite hydrogel (AT/PCS) with antimicrobial properties. The AT/PCS hydrogel exhibits excellent mechanical strength and adhesion, facilitating increased oxygen levels and strong adherence to the wound site. Moreover, it effectively regulates the wound microenvironment by combining synergistic chemodynamic therapy (CDT) and photothermal therapy (PTT) for antibacterial treatment. The AT/PCS hydrogel enhances collagen deposition and expedites wound healing in a rat model, largely due to its potent antibacterial properties.

EFFICACY OF EARLY-ONSET SEPSIS CALCULATOR IN THE PREDICTION OF ANTIBIOTICS USAGE AMONG NEONATES: A LOCAL SETTING STUDY

Early-onset sepsis (EOS) in neonates is a critical condition that requires timely diagnosis and appropriate management to prevent adverse outcomes. However, overuse of antibiotics in neonates can lead to complications, including antimicrobial resistance. The EOS calculator is a clinical tool designed to assess the risk of sepsis in neonates, helping to guide antibiotic use. Its efficacy in predicting antibiotic administration in high-risk neonates needs further evaluation. Objective: To evaluate the efficacy of the EOS calculator in predicting the use of antibiotics in neonates admitted to the neonatal intensive care unit (NICU) at a tertiary care hospital. Methods: This comparative cross-sectional study was conducted in the Pediatrics Department of Combined Military Hospital, Peshawar, from August 2020 to June 2022. A total of 982 neonates admitted to the NICU due to a high risk of infection were included. Upon admission, the attending clinician applied the EOS calculator to each neonate. However, the results were kept confidential, and routine management, including antibiotic administration, was carried out based on clinical signs and relevant investigations. The use of antibiotics within 72 hours of admission was compared to the recommendations of the EOS calculator. Statistical analysis used chi-square tests to assess the association between antibiotic use and the EOS calculator's recommendations. Results: Out of the 982 neonates included, 590 (60.1%) were male, and 392 (39.9%) were female, with a mean age of 1.38±4.53 days. Within 72 hours of admission, 562 (57.2%) neonates did not receive antibiotics according to local protocols. A statistically significant association was observed between the clinical use of antibiotics and the recommendations of the EOS calculator (p-value &lt;0.001), demonstrating that the calculator could effectively predict antibiotic needs. Conclusion: The EOS calculator proved to be an effective tool in predicting the likelihood of sepsis in neonates at high risk of infection. Its use can guide clinicians in making informed decisions about antibiotic administration, reducing unnecessary antibiotic exposure while ensuring timely treatment for those who need it. Incorporating the EOS calculator into neonatal sepsis management protocols can enhance patient outcomes and help prevent the overuse of antibiotics in neonates.

How policy advocacy promotes regulated antibiotic use: Evidence from meat duck farmers of China

Antibiotic residues resulting from the misuse of veterinary antibiotics pose a serious threat to global food safety and the ecological environment. Regulating the use of antibiotics is currently a major concern; however, existing literature on this issue remains insufficient. Therefore, to advance research in this area, this study utilizes data from 988 questionnaires collected across 9 provinces in China and employs the 3SLS systematic estimation method. It constructs an analytical framework to explore the mechanisms through which policy advocacy (PA) influences regulating antibiotics use (RAU) among meat duck farmers. Specifically, the study examines two pathways: “ PA - public opinion pressure perception (POPP) - RAU” and “ PA - moral responsibility (MR) - RAU.” Additionally, it explores the potential mechanisms through which PA impacts RAU among farmers. The results show that PA (Coef = 0.070, SE = 0.014) can promote RAU by increasing the level of POPP (Coef = 0.173, SE = 0.091). PA (Coef = 0.351, SE = 0.028) can also promote RAU by enhancing MR (Coef = 0.239, SE = 0.035). Meanwhile, this study introduces Internet use (IU) and reputational incentives (RI) as moderating variables to analyze their role in moderating the impact of PA on RAU. It was demonstrated that IU (Coef = 0.088, SE = 0.016) significantly enhances farmers' awareness of the value of RAU and amplifies the impact of PA on MR. However, IU (Coef = −0.017, SE = 0.008) was found to inhibit the effect of PA on POPP. RI fully satisfies farmers' need for “ honor “ and enhances the effectiveness of PA in promoting both POPP (Coef = 0.009, SE = 0.002) and MR (Coef = 0.058, SE = 0.004). Finally, the study proposes that the government expand PA channels, innovate methods, and combine online outreach with demonstrations to improve farmers' awareness of antibiotic use and address their reputational needs.

Prevalence of self-medication practices with antibiotics and associated factors among students in five colleges in Eritrea: a cross-sectional study

BackgroundDespite their significant contribution to reducing mortality and morbidity from infectious diseases, antibiotics face challenges due to their inappropriate use, one of which is self-medication. This study assessed the prevalence of|| self-medication with antibiotics among Eritrean college students and its associated factors.MethodsAn analytical cross-sectional study evaluated the prevalence of self-medication with antibiotics among students from five colleges from September 2019 to February 2020. Participants were selected through simple random sampling, and each participant completed a structured questionnaire covering socio-demographic characteristics, knowledge and attitudes toward antibiotics, and self-medication practices. Logistic regression analysis was employed to identify factors associated with self-medication with antibiotics.ResultsThe study distributed 380 questionnaires, with 375 returned, yielding a response rate of 98.68%. Findings revealed that 80.3% of participants were familiar with antibiotics. Additionally, 18.8% agreed with non-prescription antibiotic use for simple ailments. Of the 252 respondents who answered, 67.1% reported self-medication with antibiotics. Within the preceding six months, the prevalence of such self-medication was 34.3%. Factors associated with self-medication included college affiliation, with participants from the College of Science (COS) exhibiting lower odds (AOR = 0.38, 95% CI: 0.16–0.91, p = 0.03) compared to the College of Business and Social Sciences (CBSS) students. Those living in dormitories had 2.4 times higher odds (AOR = 2.42, 95% CI: 1.7–5.02, p = 0.017) to self-medicate compared to those living with family. Moreover, individuals unaware of antibiotic resistance had higher odds (AOR = 2.41, 95% CI: 1.24–4.7, p = 0.009) of self-medication. Attitude score was also significantly associated with self-medication (AOR = 0.88, 95% CI: 0.8–0.98, p = 0.027).ConclusionsThese results highlight the necessity for tailored educational programs to advocate for appropriate antibiotic utilization and mitigate the prevalent misuse of antibiotics among college students. Initiatives focused on increasing knowledge about the dangers linked with self-medication and advocating for conscientious antibiotic usage are essential in combating the escalating challenge of antibiotic resistance and safeguarding public health.

Pharmacies and use of antibiotics: a cross sectional study in 19 Arab countries

BackgroundThe rise of antimicrobial resistance, which is partially attributed to the overuse and/or misuse of antibiotics in health care, is one of the world’s largest public health challenges. The distribution of antibiotics in absence of a prescription in pharmacies is a significant contributor to the growing global public health crisis of antibiotic resistance. A pharmacist’s clinical and lawful knowledge of antibiotic provide has an impact on the proper way to dispense medication. There are few novel studies assessing pharmacists comprehension and experience in prescribing antibiotics in low- and middle-income countries, including those in the Arabian region.Objectives(I) assess pharmacy team members Knowledge about antibiotics as reported by individuals themselves and their behavior in dispensing antimicrobial without a prescription and (ii) find potential influences on this behavior.SettingPharmacists were chosen from various regions in Algeria, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen, based on their convenience and ease of access.MethodsA descriptive cross-sectional assessment among a random sample (n = 2833) of community pharmacists was conducted Utilizing a structured, validated, and questionnaire that underwent pilot testing, a comprehensive survey with four distinct sections covering biography, knowledge, practice, and attitude domains was employed.The main outcomeMeasures were knowledge, attitude, and practice toward dispensing antibiotics without prescription.ResultsOf the 3100 pharmacists reached, 2833 completed and return the questionnaires (response rate 91.3%). Most of the respondents were male (57.4%). Aged between 19 and 31 years old (76.2%). Most of them held a B.Sc. Degree (78.5%). Worked as staff pharmacists (73.2%). During the survey, it was discovered that there were gaps in their knowledge regarding antibiotic usage. A total of 45.7% of the respondents were unaware that antibiotics can be used as prophylaxis, while 33.3% did not recognize the consequences of making incorrect antibiotic choices. Regarding their practice patterns, 53.8% of the pharmacists admitted that they did not consistently adhere to guidelines when dispensing antibiotics. In terms of attitudes toward antibiotic usage, 36.8% disagreed with the guidelines of not supply antibiotics without a prescription, suggesting some variation in opinions among pharmacists on this matter. Additionally, a significant percentage (75%) believed that community pharmacists had qualifications to prescribe antibiotics for infections.ConclusionThe recent survey has shed light on the differences among pharmacists in regard to dispensing antibiotics without prescriptions and their understanding of resistance. The findings are concerning, indicating a deficient in of knowledge as regards the use of antibiotics. It is crucial to implement regulations and enhance education efforts to tackle the growing problem of resistance. Collaboration between healthcare professionals and awareness campaigns is essential in addressing this issue.

Multidrug-Resistant Proteus mirabilis and Other Gram-Negative Species Isolated from Native Egyptian Chicken Carcasses.

Poultry carcasses may be reservoirs for the zoonotic transmission of antimicrobial-resistant bacteria to humans and pose a major public health hazard. During the isolation of Salmonella from poultry and other foods, many of the presumptive typical Salmonella colonies on xylose lysine deoxycholate (XLD) agar were found to lack the invA gene, which is the specific target gene for Salmonella spp. Therefore, the current study aimed to estimate the prevalence and antimicrobial resistance profiles of extensively drug-resistant invA-negative non-Salmonella isolates recovered from native Egyptian chicken carcasses as presumptive Salmonella colonies on XLD agar. The non-Salmonella isolates were detected in 84% (126/150) of the examined native Egyptian chicken carcasses and classified into five genera, with prevalence rates of 64% (96/150), 14% (21/150), 6.7% (10/150), 3.3% (5/150), and 1.3% (2/150) for Proteus, Citrobacter, Shigella, Pseudomonas, and Edwardsiella, respectively. One hundred and ninety-five invA-negative, non-verified presumptive Salmonella isolates were recovered and classified at the species level into Proteus mirabilis (132/195; 67.7%), Proteus vulgaris (11/195; 5.6%), Citrobacter freundii (26/195; 13.3%), Shigella flexneri (8/195; 4.1%), Shigella sonnei (6/195; 3.1%), Shigella dysenteriae (3/195; 1.5%), Pseudomonas fluorescens (6/195; 3.1%), and Edwardsiella tarda (3/195; 1.5%). All (195/195; 100%) of these isolates showed resistance against cefaclor and fosfomycin. Additionally, these isolates showed high resistance rates of 98%, 92.8%, 89.7%, 89.2%, 89.2%, 86.7%, 80%, 78.5%, 74.4%, and 73.9% against cephalothin, azithromycin, vancomycin, nalidixic acid, tetracycline, sulfamethoxazole/trimethoprim, cefepime, gentamicin, cefotaxime, and ciprofloxacin, respectively. Interestingly, all (195/195; 100%) of the identified isolates were resistant to at least five antibiotics and exhibited an average MAR (multiple antibiotic resistance) index of 0.783. Furthermore, 73.9% of the examined isolates were classified as extensively drug-resistant, with an MAR index equal to 0.830. The high prevalence of extensively drug-resistant foodborne Proteus, Citrobacter, Shigella, Pseudomonas, and Edwardsiella isolated from native chicken carcasses poses a great hazard to public health and necessitates more monitoring and concern about the overuse and misuse of antibiotics in humans and animals. This study also recommends the strict implementation of GHP (good hygienic practices) and GMP (good manufacturing practices) in the chicken meat supply chain to protect consumer health.

Self-assembled fluorescent Zn-MOF with high specific surface area based on the coordination interaction for sensitive detection and selective removal of tetracycline antibiotic in water

As one of most common used antibiotics, tetracyclines (TCs) have been widespread used in many fields. However, the abuse of antibiotics resulted in serious environmental pollutants. Therefore, it is of great significance to develop new materials for rapid detection and effective removal of tetracyclines. In this study, a step-by-step synthesis strategy was adopted to prepare a fluorescent LMOF material Znq2@ZIF-8, and it was well characterized. Znq2@ZIF-8 showed strong green emission and has large specific surface area, with excellent stability and good recyclability. The fluorescence of Znq2@ZIF-8 can be quenched with the addition of tetracycline (TC) in the aqueous environment, demonstrating good selectivity and strong interference resistance, with a limit of detection (LOD) of 0.13 μmol∙L−1. In addition, Znq2@ZIF-8 exhibits excellent adsorption and removal abilities for TC. As a result, Znq2@ZIF-8 enables the simultaneous detection and removal of TC in aqueous environments, providing a solution for future TC pollution in water.