A Cross-Sectional Study of the Availability of Azithromycin in Local Pharmacies and Associated Antibiotic Resistance in Communities in Kilosa District, Tanzania.

Authors:
Jerusha Weaver
Jerusha Weaver
Dana Center for Preventive Ophthalmology
Beatriz Munoz
Beatriz Munoz
Wilmer Eye Institute
United States
Evan M Bloch
Evan M Bloch
Blood Systems Research Institute
United States
Christian L Coles
Christian L Coles
Bloomberg School of Public Health
Baltimore | United States
Thomas Lietman
Thomas Lietman
University of California
Sheila K West
Sheila K West
Wilmer Eye Institute
United States

Am J Trop Med Hyg 2019 May;100(5):1105-1109

Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland.

Mass drug administration (MDA) for trachoma control using azithromycin has generated concern for the development of resistant organisms. However, the contribution from azithromycin available in local pharmacies has not been studied. In Kilosa district, Tanzania, MDA stopped over 4 years ago, and this study sought to determine the availability of azithromycin in local pharmacies and correlate it with azithromycin resistance in children born after MDA. A cross-sectional survey was conducted in 644 randomly selected hamlets in Kilosa district, in which the presence of a pharmacy and the availability of azithromycin and erythromycin were determined. In 30 randomly selected hamlets, a random sample of 60 children less than 5 years were tested for azithromycin-resistant () and (), from nasopharyngeal and rectal swabs, based on disk diffusion criteria. Only 26.6% of hamlets had a pharmacy. Azithromycin and erythromycin were available in 30.8% and 89.1% of pharmacies closest to the hamlets, respectively. In the 30 communities tested for resistance, the overall prevalence of azithromycin-resistant isolates was 14%. Six of seven (87%) hamlets where azithromycin was available had resistant compared with 14 of 23 (61%) hamlets without availability. Similarly, six of seven (87%) hamlets where azithromycin was available had resistant isolates compared with 21 of 23 (70%) hamlets without availability. However, the differences were not statistically significant ( = 0.46 and 0.49, respectively). The availability of azithromycin in pharmacies in the district was limited, and a strong correlation with azithromycin-resistant or was not observed.

Download full-text PDF

Source
http://dx.doi.org/10.4269/ajtmh.18-0747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493967PMC
May 2019
1 Read

Publication Analysis

Top Keywords

availability azithromycin
16
azithromycin local
12
local pharmacies
12
kilosa district
12
azithromycin
10
azithromycin erythromycin
8
selected hamlets
8
hamlets availability
8
azithromycin resistant
8
87% hamlets
8
hamlets azithromycin
8
hamlets
8
district tanzania
8
randomly selected
8
availability
6
pharmacies
5
conducted 644
4
rectal swabs
4
nasopharyngeal rectal
4
survey conducted
4

Similar Publications