Encouraging rational antibiotic use in childhood pneumonia: a focus on Vietnam and the Western Pacific Region

Nguyen T K Phuong, Tran T Hoang, Pham H Van, Lolyta Tu, Stephen M Graham, Ben J Marais, Nguyen T K Phuong, Tran T Hoang, Pham H Van, Lolyta Tu, Stephen M Graham, Ben J Marais

Abstract

Globally, pneumonia is considered to be the biggest killer of infants and young children (aged <5 years) outside the neonatal period, with the greatest disease burden in low- and middle-income countries. Optimal management of childhood pneumonia is challenging in settings where clinicians have limited information regarding the local pathogen and drug resistance profiles. This frequently results in unnecessary and poorly targeted antibiotic use. Restricting antibiotic use is a global priority, particularly in Asia and the Western Pacific Region where excessive use is driving high rates of antimicrobial resistance. The authors conducted a comprehensive literature review to explore the antibiotic resistance profile of bacteria associated with pneumonia in the Western Pacific Region, with a focus on Vietnam. Current management practices were also considered, along with the diagnostic dilemmas faced by doctors and other factors that increase unnecessary antibiotic use. This review offers some suggestions on how these issues may be addressed.

References

    1. Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O’Brien KL, Campbell H, Black RE. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405–16. doi: 10.1016/S0140-6736(13)60222-6.
    1. WHO. World Health Statistics 2016: Monitoring health for the SDGs. 2016. . Accessed 1 Feb 2017.
    1. Naor B-Z, Carolyn M, John M, Emmalita M, Marianna T. Integrated Management of Childhood Illness (IMCI) implementation in the Western Pacific Region: information package. World Health Organ WPG. 2013. . Accessed 5 Feb 2017.
    1. Nguyen TKP, Tran TH, Robert CL, Graham SM, Marais BJ. Child pneumonia in the Western Pacific Region. Paediatr Respir Rev. 2017;21:102–10.
    1. Felmingham D, Feldman C, Hryniewicz W, Klugman K, Kohno S, Low D, Mendes C, Rodloff A. Surveillance of resistance in bacteria causing community‐acquired respiratory tract infections. Clin Microbiol Infect. 2002;8(2):12–42. doi: 10.1046/j.1469-0691.8.s.2.5.x.
    1. McIntosh K. Community-acquired pneumonia in children. N Engl J Med. 2002;346(6):429–37. doi: 10.1056/NEJMra011994.
    1. Huong PLT, Hien PT, Lan NTP, Binh TQ, Tuan DM, Anh DD. First report on prevalence and risk factors of severe atypical pneumonia in Vietnamese children aged 1–15 years. BMC Public Health. 2014;14:1304. doi: 10.1186/1471-2458-14-1304.
    1. Wu Z, Li Y, Gu J, Zheng H, Tong Y, Wu Q. Detection of viruses and atypical bacteria associated with acute respiratory infection of children in Hubei. China Respirology. 2014;19(2):218–24. doi: 10.1111/resp.12205.
    1. Yoshida L-M, Suzuki M, Thiem VD, Smith WP, Tsuzuki A, Huong VTT, Takahashi K, Miyakawa M, Anh NTH, Watanabe K. Population based cohort study for pediatric infectious diseases research in Vietnam. Trop Med health. 2014;42(2):S47–58. doi: 10.2149/tmh.2014-S07.
    1. Virkki R, Juven T, Rikalainen H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. 2002;57(5):438–41. doi: 10.1136/thorax.57.5.438.
    1. Fuller JD, Low DE. A review of Streptococcus pneumoniae infection treatment failures associated with fluoroquinolone resistance. Clin Infect Dis. 2005;41(1):118–21. doi: 10.1086/430829.
    1. Kim SH, Song J-H, Chung DR, Thamlikitkul V, Yang Y, Wang H, Lu M, So TM-K, Hsueh P-R, Yasin RM. Changing trend of antimicrobial resistance and serotypes in Streptococcus pneumoniae in Asian countries: an ANSORP study. Antimicrob Agents Chemother. 2012;56(3):1418–26. doi: 10.1128/AAC.05658-11.
    1. Peterson LR. Penicillins for treatment of pneumococcal pneumonia: does in vitro resistance really matter? Clin Infect Dis. 2006;42(2):224–33. doi: 10.1086/497594.
    1. Metlay JP. Update on community-acquired pneumonia: impact of antibiotic resistance on clinical outcomes. Curr Opin Infect Dis. 2002;15(2):163–7. doi: 10.1097/00001432-200204000-00011.
    1. Feldman C, Anderson R. Controversies in the treatment of pneumococcal community-acquired pneumonia. Future Microbiol. 2006;1(3):271–81. doi: 10.2217/17460913.1.3.271.
    1. Metlay JP, Singer DE. Outcomes in lower respiratory tract infections and the impact of antimicrobial drug resistance. Clin Microbiol Infect. 2002;8(2):1–11. doi: 10.1046/j.1469-0691.8.s.2.4.x.
    1. Oliwa JN, Marais BJ. Vaccines to prevent pneumonia in children–a developing country perspective (Epub ahead of print). Paediatr Respir Rev. 2017;22:23–30.
    1. Dagan R. Antibiotic resistance and the potential impact of pneumococcal conjugate vaccines. Commun Dis Intell Q Rep. 2003;27(2003):S134–42.
    1. Duvvuri VR, Deng X, Teatero S, Memari N, Athey T, Fittipaldi N, Gubbay JB. Population structure and drug resistance patterns of emerging non-PCV-13 Streptococcus pneumoniae serotypes 22 F, 15A, and 8 isolated from adults in Ontario, Canada. Infect Genet Evol. 2016;42:1–8. doi: 10.1016/j.meegid.2016.04.007.
    1. Sheppard C, Fry N, Mushtaq S, Woodford N, Reynolds R, Janes R, Pike R, Hill R, Kimuli M, Staves P. Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014. Euro Surveill. 2016;21(50):30423. doi: 10.2807/1560-7917.ES.2016.21.50.30423.
    1. Lee S, Kim J-H, Kim S-H, Park M, Bae S. Prevalent multidrug-resistant nonvaccine serotypes in pneumococcal carriage of healthy Korean children associated with the low coverage of the seven-valent pneumococcal conjugate vaccine. Osong Public Health Res Perspect. 2013;4(6):316–22. doi: 10.1016/j.phrp.2013.10.004.
    1. Low DE, Pichichero ME, Schaad UB. Optimizing antibacterial therapy for community-acquired respiratory tract infections in children in an era of bacterial resistance. Clin Pediatr. 2004;43(2):135–51. doi: 10.1177/000992280404300203.
    1. Su X-Y, Wen S-H, Lin L, Li C-C. Clinical characteristics of children with Streptococcus pneumoniae septicemia and drug sensitivity of Streptococcus pneumoniae. Zhongguo dang dai er ke za zhi (Chinese journal of contemporary pediatrics) 2013;15(11):995–9.
    1. Marchese A, Esposito S, Barbieri R, Bassetti M, Debbia E. Does the adoption of EUCAST susceptibility breakpoints affect the selection of antimicrobials to treat acute community-acquired respiratory tract infections? BMC Infect Dis. 2012;12(1):181. doi: 10.1186/1471-2334-12-181.
    1. Kahlmeter G. The 2014 Garrod Lecture: EUCAST–are we heading towards international agreement? J Antimicrob Chemother. 2015;70(9):2427–39. doi: 10.1093/jac/dkv145.
    1. Kassim A, Omuse G, Premji Z, Revathi G. Comparison of Clinical Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing guidelines for the interpretation of antibiotic susceptibility at a University teaching hospital in Nairobi, Kenya: a cross-sectional study. Ann Clin Microbiol Antimicrob. 2016;15(1):21. doi: 10.1186/s12941-016-0135-3.
    1. Kaur AA. Community-acquired bacteremia in Paediatrics: Epidemiology, aetiology and patterns of antimicrobial resistance in a Tertiary Care Centre, Malaysia. Med J Malaysia. 2016;71(3):117–21.
    1. Samore MH, Magill MK, Alder SC, Severina E, Morrison-de Boer L, Lyon JL, Carroll K, Leary J, Stone MB, Bradford D. High rates of multiple antibiotic resistance instreptococcus pneumoniae from healthy children living in isolated rural communities: association with cephalosporin use and intrafamilial transmission. Pediatrics. 2001;108(4):856–65. doi: 10.1542/peds.108.4.856.
    1. Hu J, Sun X, Huang Z, Wagner AL, Carlson B, Yang J, Tang S, Li Y, Boulton ML, Yuan Z. Streptococcus pneumoniae and Haemophilus influenzae type b carriage in Chinese children aged 12–18 months in Shanghai, China: a cross-sectional study. BMC Infect Dis. 2016;16:149. doi: 10.1186/s12879-016-1485-3.
    1. Hoa NQ, Trung NV, Larsson M, Eriksson B, Phuc HD, Chuc NT, Lundborg CS. Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study. BMC Infect Dis. 2010;10:85. doi: 10.1186/1471-2334-10-85.
    1. Van P, Binh P, Minh N, Morrissey I, Torumkuney D. Results from the Survey of Antibiotic Resistance (SOAR) 2009–11 in Vietnam. J Antimicrob Chemother. 2016;71(S1):i93–102. doi: 10.1093/jac/dkw069.
    1. Chen WJ, Moulton LH, Saha SK, Mahmud AA, Arifeen SE, Baqui AH. Estimation of the herd protection of Haemophilus influenzae type b conjugate vaccine against radiologically confirmed pneumonia in children under 2 years old in Dhaka, Bangladesh. Vaccine. 2014;32(8):944–8. doi: 10.1016/j.vaccine.2013.12.052.
    1. Flasche S, Takahashi K, Vu DT, Suzuki M, Nguyen TH-A, Le H, Hashizume M, Dang DA, Edmond K, Ariyoshi K. Early indication for a reduced burden of radiologically confirmed pneumonia in children following the introduction of routine vaccination against Haemophilus influenzae type b in Nha Trang, Vietnam. Vaccine. 2014;32(51):6963–70. doi: 10.1016/j.vaccine.2014.10.055.
    1. Zhu H, Wang A, Tong J, Yuan L, Gao W, Shi W, Yu S, Yao K, Yang Y. Nasopharyngeal carriage and antimicrobial susceptibility of Haemophilus influenzae among children younger than 5 years of age in Beijing, China. BMC Microbiol. 2015;15:6. doi: 10.1186/s12866-015-0350-7.
    1. Van Eldere J, Slack MP, Ladhani S, Cripps AW. Non-typeable Haemophilus influenzae, an under-recognised pathogen. Lancet Infect Dis. 2014;14(12):1281–92. doi: 10.1016/S1473-3099(14)70734-0.
    1. Hu J, Wang X, Ai T, Xie X, Liu X, Liu H, Yang L, Li H, Yang T, Zhang T. Multicenter prospective epidemiological studies on Haemophilus influenzae infection among hospitalized children with lower respiratory tract infections. Zhonghua er ke za zhi (Chinese journal of pediatrics) 2016;54(2):119–25.
    1. Mimica I, Donoso E, Howard JE, Ledermann GW. Lung puncture in the etiological diagnosis of pneumonia: a study of 543 infants and children. Amer J Dis Child. 1971;122(4):278–82. doi: 10.1001/archpedi.1971.02110040062002.
    1. Asghar R, Banajeh S, Egas J, Hibberd P, Iqbal I, Katep-Bwalya M, Kundi Z, Law P, MacLeod W, Maulen-Radovan I. Multicentre randomized controlled trial of chloramphenicol vs. ampicillin and gentamicin for the treatment of very severe pneumonia among children aged 2 to 59 months in low resource settings: a multicenter randomized trial (spear study) BMJ. 2008;336:80–4. doi: 10.1136/.
    1. Chisti MJ, Graham SM, Duke T, Ahmed T, Faruque ASG, Ashraf H, Bardhan PK, Shahid AS, Shahunja K, Salam MA. Post-discharge mortality in children with severe malnutrition and pneumonia in bangladesh. PLoS One. 2014;9(9) doi: 10.1371/journal.pone.0107663.
    1. Hughes AJ, Ariffin N, Huat TL, Molok HA, Hashim S, Sarijo J, Latif NHA, Hanifah YA, Kamarulzaman A. Prevalence of nosocomial infection and antibiotic use at a university medical center in Malaysia. Infect Control Hosp Epidemiol. 2005;26(1):100–4. doi: 10.1086/502494.
    1. Lee M, Chiu C, Chow V, Lam R, Lai R. Prevalence of hospital infection and antibiotic use at a university medical center in Hong Kong. J Hosp Infect. 2007;65(4):341–7. doi: 10.1016/j.jhin.2006.12.013.
    1. Howden BP, Davies JK, Johnson PD, Stinear TP, Grayson ML. Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection, and clinical implications. Clin Microbiol Rev. 2010;23(1):99–139. doi: 10.1128/CMR.00042-09.
    1. Song J-H, Hsueh P-R, Chung DR, Ko KS, Kang C-I, Peck KR, Yeom J-S, Kim S-W, Chang H-H, Kim Y-S. Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study. J Antimicrob Chemother. 2011;66(5):1061–9. doi: 10.1093/jac/dkr024.
    1. NPS Medicinewise. Antimicrobial resistance - it's happening right now. 2014. . Accessed 5 Feb 2017.
    1. McMullan BJ, Bowen A, Blyth CC, Van Hal S, Korman TM, Buttery J, Voss L, Roberts S, Cooper C, Tong SY. Epidemiology and Mortality of Staphylococcus aureus Bacteremia in Australian and New Zealand Children. JAMA Pediatr. 2016;170(10):979–86.
    1. Chung DR, Lee C, Kang YR, Baek JY, Kim SH, Ha YE, Kang C-I, Peck KR, Lee NY, Song J-H. Genotype-specific prevalence of heterogeneous vancomycin-intermediate Staphylococcus aureus in Asian countries. Int J Antimicrob Agents. 2015;46(3):338–41. doi: 10.1016/j.ijantimicag.2015.03.009.
    1. Vietnam Ministry of Health. First report on antibiotics use and resistance in Vietnam. 2009. . Accessed 3 Feb 2017.
    1. Pereyre S, Goret J, Bébéar C. Mycoplasma pneumoniae: current knowledge on macrolide resistance and treatment. Front Microbiol. 2016;7:974. doi: 10.3389/fmicb.2016.00974.
    1. Bell DM. Promoting appropriate antimicrobial drug use: perspective from the Centers for Disease Control and Prevention. Clin Infect Dis. 2001;33(3):245–50. doi: 10.1086/321857.
    1. Matsuda K, Narita M, Sera N, Maeda E, Yoshitomi H, Ohya H, Araki Y, Kakuma T, Fukuoh A, Matsumoto K. Gene and cytokine profile analysis of macrolide-resistant Mycoplasma pneumoniae infection in Fukuoka, Japan. BMC Infect Dis. 2013;13:591. doi: 10.1186/1471-2334-13-591.
    1. Bao F, Qu J, Liu Z, Qin X, Cao B. The clinical characteristics, treatment and outcome of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Zhonghua jie he he hu xi za zhi (Chinese journal of tuberculosis and respiratory diseases) 2013;36(10):756–61.
    1. Zhou Z, Li X, Chen X, Luo F, Pan C, Zheng X, Tan F. Macrolide-resistant Mycoplasma pneumoniae in adults in Zhejiang, China. Antimicrob Agents Chemother. 2015;59(2):1048–51. doi: 10.1128/AAC.04308-14.
    1. Hong KB, Choi EH, Lee HJ, Lee SY, Cho EY, Choi JH, Kang HM, Lee J, Ahn YM, Kang Y-H. Macrolide resistance of Mycoplasma pneumoniae, South Korea, 2000–2011. Emerg Infect Dis. 2013;19(8):1281–4. doi: 10.3201/eid1908.121455.
    1. Ho P-L, Law PY, Chan BW, Wong C-W, To KK, Chiu SS, Cheng VC, Yam W-C. Emergence of macrolide-resistant Mycoplasma pneumoniae in Hong Kong is linked to increasing macrolide resistance in multilocus variable-number tandem-repeat analysis type 4-5-7-2. J Clin Microbiol. 2015;53(11):3560–4. doi: 10.1128/JCM.01983-15.
    1. Wu PS, Chang LY, Lin HC, Chi H, Hsieh YC, Huang YC, Liu CC, Huang YC, Huang LM. Epidemiology and clinical manifestations of children with macrolide‐resistant Mycoplasma pneumoniae pneumonia in Taiwan. Pediatr Pulmonol. 2013;48(9):904–11. doi: 10.1002/ppul.22706.
    1. Xue G, Wang Q, Yan C, Jeoffreys N, Wang L, Li S, Gilbert GL, Sun H. Molecular characterizations of PCR-positive Mycoplasma pneumoniae specimens collected from Australia and China. J Clin Microbiol. 2014;52(5):1478–82. doi: 10.1128/JCM.03366-13.
    1. Spuesens EB, Sauteur PMM, Vink C, van Rossum AM. Mycoplasma pneumoniae infections–Does treatment help? J Infect. 2014;69(S1):S42–6. doi: 10.1016/j.jinf.2014.07.017.
    1. Thu TA, Rahman M, Coffin S, Harun-Or-Rashid M, Sakamoto J, Hung NV. Antibiotic use in Vietnamese hospitals: a multicenter point-prevalence study. Am J Infect Control. 2012;40(9):840–4. doi: 10.1016/j.ajic.2011.10.020.
    1. WHO. Antimicrobial resistance: global report on surveillance. 2014. . Accessed 19 Jan 2017.
    1. Hoa NQ, Chuc NTK, Phuc HD, Larsson M, Eriksson B, Lundborg CS. Unnecessary antibiotic use for mild acute respiratory infections during 28-day follow-up of 823 children under five in rural Vietnam. Tran R Soc Trop Med Hyg. 2011;105(11):628–36. doi: 10.1016/j.trstmh.2011.07.015.
    1. Nordberg P, Stalsby-Lundborg C, Tomson G. Consumers and providers-Could they make better use of antibiotics? Int J Risk Saf Med. 2005;17(3):117–25.
    1. WHO. Antimicrobial Resistance in the Western Pacific region: A review of surveillance and Health system response. 2015. . Accessed 9 Feb 2017.
    1. Capeding MR, Bravo L, Santos J, Kilgore PE, Kim SA, Balter I, Hubler R, Ye J, Moscariello M. Prospective surveillance study of invasive pneumococcal disease among urban children in the Philippines. Pediatr Infect Dis. 2013;32(10):383–9. doi: 10.1097/INF.0b013e318298dfd5.
    1. Addo-Yobo E, Chisaka N, Hassan M, Hibberd P, Lozano JM, Jeena P, MacLeod WB, Maulen I, Patel A, Qazi S. Oral amoxicillin versus injectable penicillin for severe pneumonia in children aged 3 to 59 months: a randomised multicentre equivalency study. Lancet. 2004;364(9440):1141–8. doi: 10.1016/S0140-6736(04)17100-6.
    1. Nguyen NT, Nguyen HM, Nguyen CV, Nguyen TV, Nguyen MT, Thai HQ, Ho MH, Thwaites G, Ngo HT, Baker S. The use of colistin and other critical antimicrobials on pig and chicken farms in southern Vietnam and their association with resistance in commensal Escherichia coli. Appl Environ Microbiol. 2016;82(13):3727–35. doi: 10.1128/AEM.00337-16.
    1. Liu Y-Y, Wang Y, Walsh TR, Yi L-X, Zhang R, Spencer J, Doi Y, Tian G, Dong B, Huang X. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis. 2016;16(2):161–8. doi: 10.1016/S1473-3099(15)00424-7.
    1. Davies S, Gibbens N. UK five year antimicrobial resistance strategy 2013 to 2018. Lodon: UK Goverment. 2013. . Accessed 9 Feb 2017.
    1. CDC. Antibiotic resistance threats in the United States, 2013: Centres for Disease Control and Prevention, US Department of Health and Human Services. 2013. . Accessed 9 Feb 2017.
    1. The Department of Health. Antimicrobial resistance. Australia Government (AMR). 2016. . Accessed 9 Feb 2017.
    1. Hulscher ME, van der Meer JW, Grol RP. Antibiotic use: how to improve it? Int J Med Microbiol. 2010;300(6):351–6. doi: 10.1016/j.ijmm.2010.04.003.
    1. Mills A, Brugha R, Hanson K, McPake B. What can be done about the private health sector in low-income countries? Bull World Health Organ. 2002;80(4):325–30.
    1. Hoa NQ, Larson M, Chuc NTK, Eriksson B, Trung NV, Stålsby CL. Antibiotics and paediatric acute respiratory infections in rural Vietnam: health‐care providers’ knowledge, practical competence and reported practice. Trop Med Int Health. 2009;14(5):546–55. doi: 10.1111/j.1365-3156.2009.02267.x.
    1. Do NT, Ta NT, Tran NT, Than HM, Vu BT, Hoang LB, van Doorn HR, Vu DT, Cals JW, Chandna A. Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial. Lancet Global Health. 2016;4(9):633–41. doi: 10.1016/S2214-109X(16)30142-5.
    1. Dai B, Yuan X, Liu J. Value of serum procalcitonin for the guidance of antibiotic therapy in children with lower respiratory tract infection. Zhongguo dang dai er ke za zhi (Chinese journal of contemporary pediatrics) 2015;17(12):1292–6.
    1. Addo‐Yobo E, Anh DD, El‐Sayed HF, Fox LM, Fox MP, MacLeod W, Saha S, Tuan TA, Thea DM, Qazi S. Outpatient treatment of children with severe pneumonia with oral amoxicillin in four countries: the MASS study. Trop Med Int Health. 2011;16(8):995–1006. doi: 10.1111/j.1365-3156.2011.02787.x.
    1. Singh V, Aneja S. Pneumonia–management in the developing world. Paediatr Respir Rev. 2011;12(1):52–9. doi: 10.1016/j.prrv.2010.09.011.
    1. Hazir T, Fox LM, Nisar YB, Fox MP, Ashraf YP, MacLeod WB, Ramzan A, Maqbool S, Masood T, Hussain W. Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial. Lancet. 2008;371(9606):49–56. doi: 10.1016/S0140-6736(08)60071-9.
    1. Hazir T, Nisar YB, Abbasi S, Ashraf YP, Khurshid J, Tariq P, Asghar R, Murtaza A, Masood T, Maqbool S. Comparison of oral amoxicillin with placebo for the treatment of World Health Organization–defined nonsevere pneumonia in children aged 2–59 months: a multicenter, double-blind, randomized, placebo-controlled trial in Pakistan. Clin Infect Dis. 2011;52(3):293–300. doi: 10.1093/cid/ciq142.
    1. Jehan F, Nisar MI, Kerai S, Brown N, Balouch B, Hyder Z, Ambler G, Ginsburg AS, Zaidi AK. A double blind community-based randomized trial of amoxicillin versus placebo for fast breathing pneumonia in children aged 2–59 months in Karachi, Pakistan (RETAPP) BMC Infect Dis. 2016;16:13. doi: 10.1186/s12879-015-1334-9.
    1. Van der Geest S, Hardon A. Self-medication in developing countries. J Soc Adm Pharm. 1990;7(4):199–204.
    1. Hadiyono JEP, Suryawati S, Danu SS, Santoso B. Interactional group discussion: results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities. Soc Sci Med. 1996;42(8):1177–83. doi: 10.1016/0277-9536(95)00391-6.
    1. Wertheim HF, Chandna A, Vu PD, Van Pham C, Nguyen PDT, Lam YM, Van Nguyen CV, Larsson M, Rydell U, Nilsson LE. Providing impetus, tools, and guidance to strengthen national capacity for antimicrobial stewardship in Vietnam. PLoS Med. 2013;10(5) doi: 10.1371/journal.pmed.1001429.
    1. Lee Y, Wakabayashi M. Key informant interview on antimicrobial resistance (AMR) in some countries in the western pacific region. Global Health. 2013;9:34. doi: 10.1186/1744-8603-9-34.
    1. Yin X, Song F, Gong Y, Tu X, Wang Y, Cao S, Liu J, Lu Z. A systematic review of antibiotic utilization in China. J Antimicrob Chemother. 2013;68(11):2445–52. doi: 10.1093/jac/dkt223.
    1. Xiao Y, Zhang J, Zheng B, Zhao L, Li S, Li L. Changes in Chinese policies to promote the rational use of antibiotics. PLoS Med. 2013;10(11) doi: 10.1371/journal.pmed.1001556.
    1. Hulscher ME, Grol RP, van der Meer JW. Antibiotic prescribing in hospitals: a social and behavioural scientific approach. Lancet Infect Dis. 2010;10(3):167–75. doi: 10.1016/S1473-3099(10)70027-X.
    1. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, Vlieghe E, Hara GL, Gould IM, Goossens H. Antibiotic resistance - the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–98. doi: 10.1016/S1473-3099(13)70318-9.
    1. Cho H-J, Hong S-J, Park S. Knowledge and beliefs of primary care physicians, pharmacists, and parents on antibiotic use for the pediatric common cold. Soc Sci Med. 2004;58(3):623–9. doi: 10.1016/S0277-9536(03)00231-4.
    1. Murni IK, Duke T, Kinney S, Daley AJ, Soenarto Y. Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study. Arch Dis Child. 2015;100(5):454–9. doi: 10.1136/archdischild-2014-307297.
    1. Fox C. Resisting antibiotic resistance: legal strategies to maintain man's dominion over microbes. Hous J Health L & Pol'y. 2011;12:35–62.

Source: PubMed

3
Suscribir