A cross-sectional study of the availability of azithromycin in local pharmacies and associated antibiotic resistance in communities in Kilosa district, Tanzania

Derick Ansah, Jerusha Weaver, Beatriz Munoz, Evan Bloch, Christian L. Coles, Thomas Lietman, Sheila K West

Research output: Contribution to journalArticle

Abstract

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 Streptococcus pneumoniae (Spn) and Escherichia coli (Ec), 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 Spn isolates was 14%. Six of seven (87%) hamlets where azithromycin was available had resistant Spn, compared with 14 of 23 (61%) hamlets without availability. Similarly, six of seven (87%) hamlets where azithromycin was available had resistant Ec isolates compared with 21 of 23 (70%) hamlets without availability. However, the differences were not statistically significant (P = 0.46 and 0.49, respectively). The availability of azithromycin in pharmacies in the district was limited, and a strong correlation with azithromycin-resistant Spn or Ec was not observed.

Original languageEnglish (US)
Pages (from-to)1105-1109
Number of pages5
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume100
Issue number5
DOIs
StatePublished - Jan 1 2019

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Azithromycin
Tanzania
Pharmacies
Microbial Drug Resistance
Cross-Sectional Studies
Streptococcus pneumoniae
Erythromycin
Escherichia coli
Pharmaceutical Preparations
Trachoma

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

A cross-sectional study of the availability of azithromycin in local pharmacies and associated antibiotic resistance in communities in Kilosa district, Tanzania. / Ansah, Derick; Weaver, Jerusha; Munoz, Beatriz; Bloch, Evan; Coles, Christian L.; Lietman, Thomas; West, Sheila K.

In: American Journal of Tropical Medicine and Hygiene, Vol. 100, No. 5, 01.01.2019, p. 1105-1109.

Research output: Contribution to journalArticle

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abstract = "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 Streptococcus pneumoniae (Spn) and Escherichia coli (Ec), 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 Spn isolates was 14{\%}. Six of seven (87{\%}) hamlets where azithromycin was available had resistant Spn, compared with 14 of 23 (61{\%}) hamlets without availability. Similarly, six of seven (87{\%}) hamlets where azithromycin was available had resistant Ec isolates compared with 21 of 23 (70{\%}) hamlets without availability. However, the differences were not statistically significant (P = 0.46 and 0.49, respectively). The availability of azithromycin in pharmacies in the district was limited, and a strong correlation with azithromycin-resistant Spn or Ec was not observed.",
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