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.
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“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]
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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-citationUso de antibióticos en México: revisión de problemas y políticas
Dreser, A., Wirtz, V. J., Corbett, K. K., & Echániz-Avilés, G. (2008) · Salud Pública de México · doi:10.1590/s0036-36342008001000009 · Cited by 35 · cited 1×
“The antibiotics as therapeutic group have occupied the second place in retail sales (40% without a prescription), but the first place with regards to reports on adverse reactions [8] [9].”
BackgroundSelf-citationConsumo comunitario de antimicrobianos en Chile, 2000-2008
Luis Bavestrello, F., & Ángela Cabello, M. (2011) · Revista chilena de infectología · doi:10.4067/s0716-10182011000200001 · Cited by 26 · cited 2×
“However these actions were not sustained and possibly because of this the consumption started to increase since 2002 [5].”
BackgroundLEGISLACION SOBRE ANTIBIOTICOS EN AMERICA LATINA
Ruy-Pérez, C. R., por, C., Bolis, M., & Salvatierra-Gonzalez, R. (2005) · Cited by 5
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.
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Sorted by citations
Manyi-Loh, C., Mamphweli, S., Meyer, E., & Okoh, A. (2018) · Molecules · doi:10.3390/molecules23040795 · Cited by 1,808
“, Brazil and Mexico) have implemented policies to regulate and prohibit the sales of over-the-counter antibiotics without prescription [155].”
BackgroundOcan, M., Obuku, E. A., Bwanga, F., Akena, D., Richard, S., Ogwal-Okeng, J., & Obua, C. (2015) · BMC Public Health · doi:10.1186/s12889-015-2109-3 · Cited by 504
Antibiotic stewardship in low- and middle-income countries: the same but different?
Cox, J. A., Vlieghe, E., Mendelson, M., Wertheim, H., Ndegwa, L., Villegas, M. V., Gould, I., & Levy Hara, G. (2017) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2017.07.010 · Cited by 529
Jandoc, R., Burden, A. M., Mamdani, M., Lévesque, L. E., & Cadarette, S. M. (2015) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.12.018 · Cited by 474
Auta, A., Hadi, M. A., Oga, E. F., Adewuyi, E. O., Abdu-Aguye, S. N., Adeloye, D., Strickland–Hodge, B., & Morgan, D. J. (2018) · Journal of Infection · doi:10.1016/j.jinf.2018.07.001 · Cited by 442
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
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