The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.
Impact of Over-the-Counter Restrictions on Antibiotic Consumption in Brazil and Mexico
Open accessAbstract
BACKGROUND: In 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 FINDINGS: Retail 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). CONCLUSIONS: Despite 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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A number of studies conducted in Zimbabwe, Chile, Colombia, Brazil, Mexico and Korea in addition to a study completed in Saudi Arabia found strict enforcement of existing laws to be effective in containing the non-prescribed antibiotics provision [61–65].”
From No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies (2021) · cites this paper as [63]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Outpatient antibiotic use in Europe and association with resistance: a cross-national database study
Goossens, H., Ferech, M., Vander Stichele, R., & Elseviers, M. (2005) · The Lancet · doi:10.1016/s0140-6736(05)17907-0 · Cited by 3,359 · cited 1×
“It leads to treatment failures causing deaths and an increase in use of more costly antibiotics [1,2].”
BackgroundSegmented regression analysis of interrupted time series studies in medication use research
Wagner, A. K., Soumerai, S. B., Zhang, F., & Ross-Degnan, D. (2002) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1046/j.1365-2710.2002.00430.x · Cited by 3,279 · cited 1×
“Subsequently, we used interrupted time-series analysis [18] to measure the impact of the policy implementation in each country estimating changes in level and trend in antibiotics consumption after the enforcement of the regulations.”
MethodTHE JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(1975) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1975.tb105896.x · Cited by 1,902
European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe
Ferech, M., Coenen, S., Malhotra‐Kumar, S., Dvorakova, K., Hendrickx, E., Suetens, C., & Goossens, H. (2006) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkl188 · Cited by 598 · cited 1×
“High seasonal fluctuations in antibiotics consumption suggest inadequate use for viral acute respiratory tract infections (ARI) [23].”
BackgroundTrends in antibiotic utilization in eight Latin American countries, 1997-2007
Wirtz, V. J., Dreser, A., & Gonzales, R. (2010) · Revista Panamericana de Salud Pública · doi:10.1590/s1020-49892010000300009 · Cited by 139 · cited 4×
“In both countries, penicillins, tetracyclines, quinolones, macrolides and sulfonamides were the most frequently consumed therapeutic subgroups [7], and these were therefore included as separate classes.”
BackgroundInfluentialSelf-citationImpacto de medidas regulatorias en la tendencia de consumo comunitario de antibióticos en Chile
Luis Bavestrello, F., Ángela Cabello, M., & Dunny Casanova, Z. (2002) · Revista médica de Chile · doi:10.4067/s0034-98872002001100009 · Cited by 83
Antimicrobial-Drug Use and Changes in Resistance in Streptococcus pneumoniae
Diekema, D. J., Brueggemann, A. B., & Doern, G. V. (2000) · Emerging infectious diseases · doi:10.3201/eid0605.000519 · Cited by 83
Wirtz, V. J., Herrera‐Patino, J. J., Santa‐Ana‐Tellez, Y., Dreser, A., Elseviers, M., & Vander Stichele, R. H. (2013) · Tropical Medicine & International Health · doi:10.1111/tmi.12096 · Cited by 76 · cited 4×
“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].”
BackgroundInfluentialSelf-citationEfficiency of Least-Squares Estimation of Linear Trend when Residuals Are Autocorrelated
Chipman, J. S. (1979) · Econometrica · doi:10.2307/1912350 · Cited by 73
Dreser, A., Vázquez‐Vélez, E., Treviño, S., & Wirtz, V. J. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-1051 · Cited by 53 · cited 4×
“Indeed, the Mexican government justified the antibiotic regulation in 2010 [10] arguing that it would prevent harmful self-medication with antibiotics that had led to delayed medical diagnosis of lifethreatening complications during the influenza epidemic [9].”
BackgroundInfluentialSelf-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Bavestrello L, Cabello A, Casanova D (2002) [Impact of regulatory measures in the trends of community consumption of antibiotics in Chile]. Revista médica de Chile 130: 1265–1272. Available: http://www.ncbi.nlm.nih.gov/pubmed/12587509. Accessed 2013 April 17.
Cited by
Sorted by citations
Items 101–134 of 134
Öztürk, H., & Kayaaslan, B. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2026.1762561 · Cited by 1
Leçons tirées de dix pays sur la réglementation des antimicrobiens pour les animaux d’élevage
Baral, P., Danik, M., & Hoffman, S. J. (2019) · Canadian Journal of Law and Society / Revue Canadienne Droit et Société · doi:10.1017/cls.2019.25 · Cited by 1
Guimarães, F. S., Cata-Preta, B. O., Barros, A. J. D., Matijasevich, A., Santos, I. S., da Silveira, M. F., Silveira, M. P. T., & Bertoldi, A. D. (2022) · Cadernos de Saúde Pública · doi:10.1590/0102-311xpt168021 · Cited by 1
Alridha, A. M. A., AL-GBURI, K. M. H., Abbood, S. K., Yasir, A., & Hussam, D. (2022) · Journal of Public Health and Development · doi:10.55131/jphd/2023/210102 · Cited by 1
Impact of COVID-19 on antibiotic prescriptions for Brazilian children
Fiol, F. D. S. D., & Andrade, I. P. D. (2022) · Scientific Reports · doi:10.1038/s41598-022-27212-9 · Cited by 1
Antimicrobial Stewardship in Africa
Mpundu, M. M., Chanda, R., & Khan, R. (2023) · Springer eBooks · doi:10.1007/978-3-031-23796-6_2 · Cited by 1
Electronic data sources for drug utilization research and healthcare decision-making in Mexico
Santa‐Ana‐Téllez, Y., Dreser, A., Pastrana, L. I. C., Salas, M., Sánchez‐Salgado, J. C., Gómez-Galicia, D. L., Leal, L. F., & Lopes, L. C. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13216-4 · Cited by 1
“Some researchers have managed free access through well-framed research protocols submitted to the company [19].”
Self-citationReply to “Decrease in Penicillin Sales in Brazil after Over-the-Counter Restrictions”
Santa‐Ana‐Téllez, Y., Mantel-Teeuwisse, A. K., Leufkens, H. G. M., & Wirtz, V. J. (2015) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.01128-15 · Cited by 1
“In a previous study, we reported these changes in the overall use of antibiotics and stratified the data by subgroups measured in defined daily doses per 1,000 inhabitants per day (DDD/TID) (2).”
Self-citationUso de antibióticos en un hospital Ecuatoriano de tercer nivel, ocho años de seguimiento
Romo-Castillo, H. F. (2020) · doi:10.11606/t.17.2020.tde-20082020-114306 · Cited by 1
Schuck‐Paim, C., Taylor, R. J., Alonso, W. J., Weinberger, D. M., & Simonsen, L. (2018) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/270637
“For example, in 2010 Brazil banned over-the-counter sale of antibiotics, resulting in a documented and substantial reduction in consumption of penicillin, sulfonamide and macrolide antibiotics in the post-PCV10 period (23).”
BackgroundOn the design of stimulation trials in the oil field: A power analysis of intervention studies
D’Ottaviano, F., & Patil, P. D. (2018) · Journal of Petroleum Science and Engineering · doi:10.1016/j.petrol.2018.08.068
Pharmacists’ provision and public’s use of antibiotics for common infections in Sri Lanka
Zawahir, S. (2019) · The Sydney eScholarship Repository (The University of Sydney)
Inhibition of Biotin Carboxylase by Three Antibacterial Compounds
Craft, M. (2022) · Louisiana State University · doi:10.31390/gradschool_dissertations.5751
Nonprescription fish antibiotics:
Roberts, E. P., Veltri, C. A., Lozoya, M., Agostini, G., & Mitchell, J. C. (2022) · JADA Foundational Science · doi:10.1016/j.jfscie.2022.100015
KAMKOUM, A. C. (2023) · OSF Preprints (OSF Preprints) · doi:10.31219/osf.io/53qbm
Moura, M. L. D. N. (2022) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2022.tde-19042023-142951
Promoting appropriate use of medicines in a healthcare system
Bennie, M., Kurdi, A. B., & Santa‐Ana‐Téllez, Y. (2024) · Wiley eBooks · doi:10.1002/9781119911685.ch22
Saxena, S., Singh, S., Sahoo, N. R., Kumar, S., Sharma, N., Garg, Y., & Singh, A. (2025) · Anti-Infective Agents · doi:10.2174/0122113525356066250204064337
Belachew, S. A., Hall, L., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.13578729
Lin, L., Alam, P., Fearon, E., & Hargreaves, J. R. (2020) · Figshare · doi:10.6084/m9.figshare.13120782
Belachew, S. A., Hall, L., Erku, D., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.14728678
Belachew, S. A., Hall, L., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.13578732
Lin, L., Alam, P., Fearon, E., & Hargreaves, J. R. (2020) · Figshare · doi:10.6084/m9.figshare.13120785
Belachew, S. A., Hall, L., & Selvey, L. A. (2022) · Figshare · doi:10.6084/m9.figshare.19687387
Belachew, S. A., Hall, L., & Selvey, L. A. (2022) · Figshare · doi:10.6084/m9.figshare.19687390
Lin, L., Alam, P., Fearon, E., & Hargreaves, J. R. (2020) · Figshare · doi:10.6084/m9.figshare.13120776
Belachew, S. A., Hall, L., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.13578738
Belachew, S. A., Hall, L., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.13578735
Lin, L., Alam, P., Fearon, E., & Hargreaves, J. R. (2020) · Figshare · doi:10.6084/m9.figshare.13120779
Belachew, S. A., Hall, L., Erku, D., & Selvey, L. A. (2021) · Figshare · doi:10.6084/m9.figshare.14728681
Belachew, S. A., Hall, L., & Selvey, L. A. (2023) · Figshare · doi:10.6084/m9.figshare.23902936
García-Gómez, J., Ambriz-Alarcón, M. A., Rubio-Mora, B. R., Jave‐Suárez, L. F., Aguilar‐Lemarroy, A., Villaseñor-García, M. M., Hernández‐Flores, G., Rodríguez-Lora, M. C., Hernández-Flores, T. D. J., Íñiguez-Gutiérrez, L., et al. (2026) · Antibiotics · doi:10.3390/antibiotics15101005
“…the 2010 restriction of over-the-counter antibiotic sales coincided with a fall in national consumption from 10.5 to 7.5 DDD/1000 inhabitants/day [26], and the Estrategia Nacional de Acción contra la Resistencia a los Antimicrobianos, made mandatory in 2018, aligned national policy with the WHO…”
Influential
Metadata
- Authors
- Santa-Ana-Tellez, Y., Mantel-Teeuwisse, A. K., Dreser, A., Leufkens, H. G. M., & Wirtz, V. J.
- Affiliations
- Utrecht University (NL)
- Boston University (US)
- Corresponding author
- Mantel-Teeuwisse, Aukje K.
- Leufkens, Hubert G. M.
- Wirtz, Veronika J.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-10-16
- Volume
- 8
- Issue
- 10
- Pages
- e75550
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3797702
- OpenAlex
- W1978318446
- Cited by
- 135
- References
- 13
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 12 · 2023: 8 · 2022: 21 · 2021: 19 · 2020: 18 · 2019: 13 · 2018: 11 · 2017: 5 · 2016: 8 · 2015: 10 · 2014: 2
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- ZonMw
- College ter Beoordeling van Geneesmiddelen
- Consejo Nacional de Ciencia y Tecnología
- Top Institute Pharma
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Keywords
- antibiotic use, defined daily doses, penicillin, sulfonamides, macrolides, antimicrobial policy, Brazil, Mexico, Latin America
- MeSH terms
- Anti-Bacterial Agents, Brazil, Drug Utilization, Nonprescription Drugs, Humans, Mexico, Prescription Drug Misuse
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
