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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

ffect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, Sao Paulo, Brazi

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Author(s):
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Moura, Maria L. [1] ; Boszczowski, Icaro [1] ; Blaque, Manuela [2] ; Mussarelli, Rafael M. [2] ; Fossaluza, Victor [2] ; Pierrotti, Ligia C. [3] ; Campana, Gustavo [3] ; Brandileone, Maria C. [4] ; Zanella, Rosemeire [4] ; Almeida, Samanta C. G. [4] ; Levin, Anna S. [5]
Total Authors: 11
Affiliation:
[1] Univ Sao Paulo, Hosp Clin, Sao Paulo - Brazil
[2] Univ Sao Paulo, Inst Matemat & Estat, Sao Paulo - Brazil
[3] Diagnost Amer Lab, Sao Paulo - Brazil
[4] Natl Lab Meningitis & Pneumococcal Infect, Sao Paulo - Brazil
[5] Univ Sao Paulo, Fac Med, Rua Ovidio Pires de Campos 225, 6 Andar, Sala 629, BR-05403010 Sao Paulo - Brazil
Total Affiliations: 5
Document type: Journal article
Source: Emerging Infectious Diseases; v. 28, n. 1, p. 180-187, JAN 2022.
Web of Science Citations: 0
Abstract

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. (AU)

FAPESP's process: 11/19128-1 - Spatial analysis of the occurrence of primary bloodstream infections caused by multi-resistant bacteria in intensive care units of the State of São Paulo
Grantee:Anna Sara Shafferman Levin
Support Opportunities: Regular Research Grants