Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review
ABSTRACT: Objectives: Inappropriate antibiotic dispensing is one of the key drivers of antibiotic resistance. This review documents the effectiveness of interventions aimed at improving antibiotic dispensing practices at the community level by drug dispensers in low- and middle-income countries (LM...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716522000686 |
| _version_ | 1818230798978908160 |
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| author | Samuel Afari-Asiedu Martha Ali Abdulai Alma Tostmann Ellen Boamah-Kaali Kwaku Poku Asante Heiman F.L. Wertheim Marlies Hulscher |
| author_facet | Samuel Afari-Asiedu Martha Ali Abdulai Alma Tostmann Ellen Boamah-Kaali Kwaku Poku Asante Heiman F.L. Wertheim Marlies Hulscher |
| author_sort | Samuel Afari-Asiedu |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Inappropriate antibiotic dispensing is one of the key drivers of antibiotic resistance. This review documents the effectiveness of interventions aimed at improving antibiotic dispensing practices at the community level by drug dispensers in low- and middle-income countries (LMIC). Methods: We conducted a systematic search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science (11 November 2019). Studies were included if they reported data on the outcome measure: appropriate dispensing of medicine including antibiotics. The effectiveness of studies was assessed based on quantitative results reported in the studies included. Results: A total of 1158 articles were screened. Thirteen studies from Asia (six), Africa (five) and South America (one) and one study from both Africa and Asia were included in this review. Nine (69.2%) studies reported significant effectiveness of interventions on all or more than 50% of antibiotic-related outcomes. Cochrane Effective Practice and Organization of Care interventions frequently applied were educational meetings (9/13), distribution of educational materials (7/13), educational outreach meetings (7/13), reminders (6/13), local consensus processes (6/13), distribution of supplies (6/14) and clinical practice guidelines (4/14), Nine studies reported on stakeholder involvement. Conclusion: This review shows that it is possible to improve antibiotic dispensing practices at the community level in LMIC. Stakeholders’ involvement was key in the design and implementation of interventions. |
| first_indexed | 2024-12-12T10:40:14Z |
| format | Article |
| id | doaj.art-1d93ecdc21af4e549255f33e03ada49c |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-12T10:40:14Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-1d93ecdc21af4e549255f33e03ada49c2022-12-22T00:27:04ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-06-0129259274Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic reviewSamuel Afari-Asiedu0Martha Ali Abdulai1Alma Tostmann2Ellen Boamah-Kaali3Kwaku Poku Asante4Heiman F.L. Wertheim5Marlies Hulscher6Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, Ghana; Radboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands; Corresponding author. Mailing address: Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, P.O Box 200, Kintampo, Bono East Region, Ghana.Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, GhanaRadboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The NetherlandsKintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, GhanaKintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, GhanaRadboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The NetherlandsRadboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The NetherlandsABSTRACT: Objectives: Inappropriate antibiotic dispensing is one of the key drivers of antibiotic resistance. This review documents the effectiveness of interventions aimed at improving antibiotic dispensing practices at the community level by drug dispensers in low- and middle-income countries (LMIC). Methods: We conducted a systematic search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science (11 November 2019). Studies were included if they reported data on the outcome measure: appropriate dispensing of medicine including antibiotics. The effectiveness of studies was assessed based on quantitative results reported in the studies included. Results: A total of 1158 articles were screened. Thirteen studies from Asia (six), Africa (five) and South America (one) and one study from both Africa and Asia were included in this review. Nine (69.2%) studies reported significant effectiveness of interventions on all or more than 50% of antibiotic-related outcomes. Cochrane Effective Practice and Organization of Care interventions frequently applied were educational meetings (9/13), distribution of educational materials (7/13), educational outreach meetings (7/13), reminders (6/13), local consensus processes (6/13), distribution of supplies (6/14) and clinical practice guidelines (4/14), Nine studies reported on stakeholder involvement. Conclusion: This review shows that it is possible to improve antibiotic dispensing practices at the community level in LMIC. Stakeholders’ involvement was key in the design and implementation of interventions.http://www.sciencedirect.com/science/article/pii/S2213716522000686Antibiotic dispensingInterventionsOver-the-counter medicine sellersCommunity health postLow- and middle-income countries |
| spellingShingle | Samuel Afari-Asiedu Martha Ali Abdulai Alma Tostmann Ellen Boamah-Kaali Kwaku Poku Asante Heiman F.L. Wertheim Marlies Hulscher Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review Journal of Global Antimicrobial Resistance Antibiotic dispensing Interventions Over-the-counter medicine sellers Community health post Low- and middle-income countries |
| title | Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review |
| title_full | Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review |
| title_fullStr | Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review |
| title_full_unstemmed | Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review |
| title_short | Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: a systematic review |
| title_sort | interventions to improve dispensing of antibiotics at the community level in low and middle income countries a systematic review |
| topic | Antibiotic dispensing Interventions Over-the-counter medicine sellers Community health post Low- and middle-income countries |
| url | http://www.sciencedirect.com/science/article/pii/S2213716522000686 |
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