Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, Sao Paulo, Brazil
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Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
CENTERS DISEASE CONTROL & PREVENTION
Autores
BLAQUE, Manuela
MUSSARELLI, Rafael M.
FOSSALUZA, Victor
PIERROTTI, Ligia C.
CAMPANA, Gustavo
BRANDILEONE, Maria C.
ZANELLA, Rosemeire
ALMEIDA, Samanta C. G.
Citação
EMERGING INFECTIOUS DISEASES, v.28, n.1, p.180-187, 2022
Resumo
Although restricting over-the-counter (OTC) antimicrobial drug sales is recommended globally, no data have shown 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 Sao 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 beta-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.
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Referências
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