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      Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study.

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          Abstract

          India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India.

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          Totally drug-resistant tuberculosis in India.

          Z F Udwadia, R A Amale, K. K. Ajbani … (2012)
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            Mechanisms of drug resistance in Mycobacterium tuberculosis.

            Y. Zhang, W W Yew (2009)
            The increasing emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in the era of human immunodeficiency virus (HIV) infection presents a major threat to effective control of TB. Drug resistance in Mycobacterium tuberculosis arises from spontaneous chromosomal mutations at low frequency. Clinical drug-resistant TB largely occurs as a result of man-made selection during disease treatment of these genetic alterations through erratic drug supply, suboptimal physician prescription and poor patient adherence. Molecular mechanisms of drug resistance have been elucidated for the major first- and second-line drugs rifampicin, isoniazid, pyrazinamide, ethambutol, the aminoglycosides and the fluoroquinolones. The relationship between drug resistance in M. tuberculosis strains and their virulence/transmissibility needs to be further investigated. Understanding the mechanisms of drug resistance in M. tuberculosis would enable the development of rapid molecular diagnostic tools and furnish possible insights into new drug development for the treatment of TB.
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              International standards for tuberculosis care.

              Dermot Maher, Mukund Uplekar, Philip C. Hopewell … (2006)
              Part of the reason for failing to bring about a more rapid reduction in tuberculosis incidence worldwide is the lack of effective involvement of all practitioners-public and private-in the provision of high quality tuberculosis care. While health-care providers who are part of national tuberculosis programmes have been trained and are expected to have adopted proper diagnosis, treatment, and public-health practices, the same is not likely to be true for non-programme providers. Studies of the performance of the private sector conducted in several different parts of the world suggest that poor quality care is common. The basic principles of care for people with, or suspected of having, tuberculosis are the same worldwide: a diagnosis should be established promptly; standardised treatment regimens should be used with appropriate treatment support and supervision; response to treatment should be monitored; and essential public-health responsibilities must be carried out. Prompt and accurate diagnosis, and effective treatment are essential for good patient care and tuberculosis control. All providers who undertake evaluation and treatment of patients with tuberculosis must recognise that not only are they delivering care to an individual, but they are also assuming an important public-health function. The International Standards for Tuberculosis Care (ISTC) describe a widely endorsed level of care that all practitioners should seek to achieve in managing individuals who have, or are suspected of having, tuberculosis. The document is intended to engage all care providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative, and extra-pulmonary tuberculosis, tuberculosis caused by drug-resistant Mycobacterium tuberculosis complex, and tuberculosis combined with HIV infection.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Lancet Infect Dis
                Title: The Lancet. Infectious diseases
                Publisher: Elsevier BV
                ISSN (Electronic): 1474-4457
                ISSN (Print): 1473-3099
                Publication date (Electronic): Nov 2016
                Volume: 16
                Issue: 11
                Affiliations
                [1 ] McGill International Tuberculosis Centre & Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
                [2 ] Development Research Group, The World Bank, Washington, DC, USA.
                [3 ] Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
                [4 ] ACCESS Health International, Hyderabad, India.
                [5 ] Institute for Social and Economic Research on Development and Democracy, Delhi, India.
                [6 ] Department of Anthropology, Johns Hopkins University, Baltimore, MD, USA.
                [7 ] Development Research Group, The World Bank, Washington, DC, USA; Center for Policy Research, New Delhi, India.
                [8 ] McGill International Tuberculosis Centre & Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Manipal McGill Center for Infectious Diseases, Manipal University, Manipal, India. Electronic address: madhukar.pai@mcgill.ca.
                Article
                Publisher Item ID: S1473-3099(16)30215-8
                DOI: 10.1016/S1473-3099(16)30215-8
                PMC ID: 5067371
                PubMed ID: 27568359
                SO-VID: 2bc7b341-04fa-47af-ad2e-b21e0f4675f1
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