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Pharmacy-based dispensing of antimicrobial agents without prescription in India: appropriateness and cost burden in the private sector.

Overview of attention for article published in Antimicrobial Resistance and Infection Control, December 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Good Attention Score compared to outputs of the same age and source (72nd percentile)

Mentioned by

news
1 news outlet
twitter
9 tweeters

Citations

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26 Dimensions

Readers on

mendeley
97 Mendeley
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Title
Pharmacy-based dispensing of antimicrobial agents without prescription in India: appropriateness and cost burden in the private sector.
Published in
Antimicrobial Resistance and Infection Control, December 2015
DOI 10.1186/s13756-015-0098-8
Pubmed ID
Authors

Anita Shet, Suba Sundaresan, Birger C Forsberg, Birger C. Forsberg

Abstract

Inappropriate antibiotic use for treatment of common self-limiting infections is a major problem worldwide. We conducted this study to determine prevalence of non-prescription sale of antimicrobial drugs by pharmacies in Bangalore, India, and to assess their associated avoidable cost within the Indian private healthcare sector. Between 2013 and 2014, two researchers visited 261 pharmacies with simulated clinical scenarios; upper respiratory tract infection in an adult and acute gastroenteritis in a child. Using a pre-defined algorithm, the researchers recorded questions asked by the pharmacist, details of medicines dispensed, and instructions regarding drug allergies, dose and side effects. Antimicrobial drugs were obtained without prescription from 174 of 261 (66.7 %) pharmacies visited. Instructions regarding dose of these drugs were given by only 58.0 % pharmacies. Only 18.4 % (16/87) of non-antimicrobial-dispensing pharmacies cited the need for a prescription by a medical practitioner. None gave advice on potential side effects or possible drug allergies. In the upper respiratory infection simulation, 82 (71.3 %) of the 115 pharmacies approached dispensed antimicrobials without a prescription. The most common antimicrobial drug prescribed was amoxicillin (51.2 %), followed by azithromycin and ciprofloxacin (12.2 % each). Among 146 pharmacies where acute gastroenteritis was simulated, 92 (63.0 %) dispensed antimicrobials. Common ones were fluoroquinolones (66.3 %), particularly norfloxacin in combination with metronidazole. Standard treatment for diarrhea such as oral rehydration solution and zinc was prescribed by only 18 of 146 (12.3 %) pharmacies. Assuming the average cost of a 5-day course of common antimicrobials in India is $1.93, with 2.5 and 2.1 annual episodes of adult upper respiratory and childhood gastrointestinal infections respectively, and with 30-45 % of the population of 1.3 billion visiting pharmacies, the estimated cost of unnecessary antimicrobial drugs dispensed by pharmacies in India would range from $1.1 to 1.7 billion. The study shows that dispensing of antimicrobial drugs without prescription by pharmacies in the private sector in India within an urban setting was unacceptably high, thus placing a high burden on healthcare expenditure. There is an urgent need to institute measures to curb unnecessary antimicrobial usage in India, address market incentives and involve pharmacists as partners for creating awareness among communities.

Twitter Demographics

The data shown below were collected from the profiles of 9 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 1%
Unknown 96 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 18 19%
Student > Master 16 16%
Researcher 14 14%
Unspecified 13 13%
Student > Ph. D. Student 12 12%
Other 24 25%
Readers by discipline Count As %
Medicine and Dentistry 28 29%
Unspecified 18 19%
Pharmacology, Toxicology and Pharmaceutical Science 18 19%
Nursing and Health Professions 8 8%
Immunology and Microbiology 5 5%
Other 20 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 14. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 December 2015.
All research outputs
#1,142,363
of 13,515,188 outputs
Outputs from Antimicrobial Resistance and Infection Control
#192
of 691 outputs
Outputs of similar age
#36,342
of 358,648 outputs
Outputs of similar age from Antimicrobial Resistance and Infection Control
#20
of 77 outputs
Altmetric has tracked 13,515,188 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 691 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.8. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 358,648 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 77 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.