孟加拉国抗生素使用模式及耐药事件研究

M. Islam, K. Sikdar, Asm Monjur Al Hossain, A. Faroque
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引用次数: 6

摘要

抗生素耐药性是目前全球卫生专业人员面临的最大挑战之一。细菌正在对常用的抗生素产生耐药性,已经确定了导致耐药性的各种因素。抗生素产品质量差、制药公司不道德的营销行为、医生不合理使用抗生素以及患者不遵守规定等因素在孟加拉国也很常见。为开展本研究,首先收集达卡市各诊断中心的临床分离株,对常用抗生素进行药敏试验,评估耐药程度;通过在孟加拉国各地收集不同仿制药产品,并采用高效液相色谱法进行药物含量测定,对产品质量进行评价。最后,对近期服用或曾服用抗生素的患者进行问卷调查,并对收集到的数据进行统计分析,以评估患者的不依从性。调查结果显示,收集到的大肠杆菌分离株中有80%以上对目前使用的抗生素耐药,如阿奇霉素、环丙沙星、阿莫西林、头孢克肟、头孢呋辛和莫西沙星。收集到的金黄色葡萄球菌(金黄色葡萄球菌)分离物也是如此。无论生产厂家是否具有较高的市场价值,大多数产品在药物含量和溶出度方面的质量都是良好的。患者调查显示,82%停止抗生素治疗是由于粗心(49%),错误的治愈感(36%)和高费用(15%)。达卡大学药学院。科学通报,18(2):135-143,2019 (12)
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Study on the Pattern of Antibiotic Use Including the Resistance Episodes in Bangladesh
Antibiotic resistance is currently one of the biggest challenges faced by the health professionals worldwide. Bacteria are becoming resistant to commonly used antibiotics and various factors have been identified that are responsible for the resistance. Factors like poor quality of antibiotic products, unethical marketing practices by pharmaceutical companies, irrational use of antibiotics by the physicians and patient incompliance are also common in Bangladesh. To carry out this study, firstly the extent of antibiotic resistance was evaluated by collecting clinical isolates from various diagnostic centers of Dhaka City and conducting antibiotic susceptibility test against commonly used antibiotics. The product quality was evaluated by collecting antibiotic products of different generics from various locations around Bangladesh and then performing drug content assay by HPLC method. Finally, to evaluate patient incompliance, a questionnaire-based survey was conducted on patients who took or had taken antibiotics recently and the collected data was analyzed statistically. The result of the investigation reveals that more than 80% of the collected Escherichia coli (E. coli) isolates were resistant to currently used antibiotics like, azithromycin, ciprofloxacin, amoxicillin, cefixime, cefuroxime, and moxifloxacin. Similar holds true for the collected Staphylococcus aureus (S. aureus) isolates. The product quality in terms of drug content and dissolution was good for most products irrespective of whether the manufacturer had a high market value or not. Patients survey revealed that 82% discontinued antibiotic therapy was due to carelessness (49%), a false sense of cure (36%) and high cost (15%). Dhaka Univ. J. Pharm. Sci. 18(2): 135-143, 2019 (December)
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