The Impact of Restricting Over-the-Counter Sales of Antimicrobial Drugs Preliminary Analysis of National Data

Autor(es)

Moura, Maria Luisa ^[1] ; Boszczowski, Icaro ^[1] ; Mortari, Naima ^[1] ; Barrozo, Ligia Vizeu ^[2] ; Chiaravalloti Neto, Francisco ^[3] ; Lobo, Renata Desordi ^[1] ; Pedroso de Lima, Antonio Carlos ^[4] ; Levin, Anna S. ^{[5, 6, 1]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Hosp Clin, Infect Control Dept, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Filosofia Letras & Ciencias Humanas, Dept Geog, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Saude Publ, Dept Epidemiol, BR-01255 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Inst Math & Stat, Dept Stat, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, LIM 54, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Fac Med, Dept Infect Dis, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: MEDICINE; v. 94, n. 38 SEP 2015.
• Citações Web of Science: 10

Resumo

To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010.Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008-2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit.In private pharmacies the effect of the restrictive law was statistically significant (P<0.001) with an estimated decrease in DDD/TID of 1.87 (s.e.= 0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P<0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e.=0.01) whereas after the law, the estimated slope was 0.03 (s.e.=0.01). As for the nonprivate channels, no difference in sales was observed (P=0.643). The impact in the South and Southeast (more developed) regions was higher than in the North, Northeast, and Mid-West. The state capitals had a 19% decrease, compared with 0.8% increase in the rest of the states.Before the law, the sales of antimicrobial drugs were steadily increasing. From November 2010, with the restrictive law, there was an abrupt drop in sales followed by an increase albeit at a significantly lower rate. The impact was higher in regions with better socio-economic status. (AU)

• Processo FAPESP: 11/19128-1 - Análise espacial da ocorrência de infecções bacterianas da corrente sanguínea causadas por agentes multirresistentes em unidades de terapia intensiva do estado de São Paulo
• Beneficiário: Anna Sara Shafferman Levin
• Modalidade de apoio: Auxílio à Pesquisa - Regular