A random survey of the prevalence of falsified and substandard antibiotics in the Lao PDR.


Journal

The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617

Informations de publication

Date de publication:
29 05 2022
Historique:
received: 07 07 2021
accepted: 19 10 2021
pubmed: 10 2 2022
medline: 3 6 2022
entrez: 9 2 2022
Statut: ppublish

Résumé

In 2012, a stratified random survey, using mystery shoppers, was conducted to investigate the availability and quality of antibiotics sold to patients in the private sector in five southern provinces of the Lao People's Democratic Republic (Laos). A total of 147 outlets were sampled in 10 districts. The active pharmaceutical ingredient (API) content measurements for 909 samples, including nine APIs (amoxicillin, ampicillin, ceftriaxone, ciprofloxacin, doxycycline, ofloxacin, sulfamethoxazole, tetracycline and trimethoprim), were determined using HPLC. All the analysed samples contained the stated API and we found no evidence for falsification. All except one sample had all the units tested with %API values between 75% and 125% of the content stated on the label. However, we identified the presence of substandard antibiotics: 19.6% (201/1025) of samples had their units outside the 90%-110% content of the label claim and 18.3% (188/1025) of the samples had units outside the International Pharmacopoeia/United States Pharmacopoeia assay (percentage of label claim) specifications. Trimethoprim had a high number of samples [51.6% (64)] with units below the limit range, followed by ceftriaxone [42.9% (3)] and sulfamethoxazole [34.7% (43)]. Doxycycline, ofloxacin and ciprofloxacin had the highest number of samples with high API content: 43.7% (38), 14.7% (10) and 11.8% (2), respectively. Significant differences in %API were found between stated countries of manufacture and stated manufacturers. With the global threat of antimicrobial resistance on patient outcomes, greater understanding of the role of poor-quality antibiotics is needed. Substandard antibiotics will have reduced therapeutic efficacy, impacting public health and control of bacterial infections.

Identifiants

pubmed: 35137095
pii: 6521963
doi: 10.1093/jac/dkab435
pmc: PMC7614350
mid: EMS171924
doi:

Substances chimiques

Anti-Bacterial Agents 0
Ciprofloxacin 5E8K9I0O4U
Ceftriaxone 75J73V1629
Ofloxacin A4P49JAZ9H
Trimethoprim AN164J8Y0X
Sulfamethoxazole JE42381TNV
Doxycycline N12000U13O

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1770-1778

Subventions

Organisme : Wellcome Trust
ID : 106698
Pays : United Kingdom
Organisme : International Development
Organisme : Bill and Melinda Gates Foundation to the London School of Hygiene and Tropical Medicine (LSHTM)
Organisme : Wellcome Trust of Great Britain and the Artemisinin Combination Therapy Consortium (ACTc)
Organisme : London School of Hygiene and Tropical Medicine (LSHTM)
Organisme : French Ministry of Foreign Affairs

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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Auteurs

Patricia Tabernero (P)

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
Public Health Unit, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain.

Isabel Swamidoss (I)

Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.

Mayfong Mayxay (M)

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, Churchill Hospital, University of Oxford, Oxford, UK.
Institute of Research and Education Development, University of Health Sciences, Vientiane, Lao PDR.

Maniphone Khanthavong (M)

Centre of Malariology, Parasitology and Entomology (CMPE), Vientiane, Lao PDR.

Chindaphone Phonlavong (C)

Bureau of Food and Drug Inspection (BFDI), Ministry of Health, Government of the Lao PDR, Vientiane, Lao PDR.

Chanthala Vilayhong (C)

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.

Chanvilay Sichanh (C)

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.

Sivong Sengaloundeth (S)

Food and Drug Department (FDD), Ministry of Health, Government of the Lao PDR, Vientiane, Lao PDR.

Michael D Green (MD)

Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.

Paul N Newton (PN)

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, Churchill Hospital, University of Oxford, Oxford, UK.
Infectious Diseases Data Observatory, Nuffield Department of Medicine, Churchill Hospital, University of Oxford, Oxford, UK.
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.

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Classifications MeSH