IMPACT OF REGULATORY MEASURES ON ANTIBIOTIC SALES IN CHILE'

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IMPACT OF REGULATORY MEASURES ON ANTIBIOTIC SALES
IN CHILE. Bavestrello L, Cabello
A. Gustavo Fricke Hospital.Viña del Mar.CHILE
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Introduction

• Antibiotics are drugs used in the prevention and
  treatment of infections caused by pathogenus
  microorganisms.
• Its use must be linked to a medical prescription
  since they can present adverse reactions and its
  use is related to an increase of bacterial
  resistance.
• There is a relation between antibiotic
  consumption in the community and the appearance
  and spreading of resistance

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Introduction

• Therefore, the indiscriminate use of antibiotics
  increases the appearance of bacterial resistence
  and forces the use of more expensive
  alternatives. The Chilean Ministry of Health is
  regulating the consumption of antibiotics since
  September 1999, as a strategy to encourage the
  rational use of antibiotics.

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OBJECTIVE

• To study the impact of the 1999 regulatory
  measures on antibiotic sales implemented by the
  Chilean Ministry of Health in community
  pharmacies, determined in three ways
• in DDD/1000 inh.-day as a consumption unit,
• in sale units,
• expressed in USD,
• during seven years, from 1996 to 2002.

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METHOD

• 1) Census Population Data of Chile.
• 2) Annual sales data for antibiotics I.M.S.
  1996 to 2002.
• 3) Definition of the consumption unit used
• DDD/1000 inhabitants-day.
• 4) Calculation of the Nº of DDD sold for each
• antibiotic
• DDD/1000 inhabitants/day sold grams x 1000
• DDD spe.x Nºdays x Population

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• Intervention
• The basis of action Plan to assure antibiotics
  rational use
• The antibiotic use must respond to a diagnosis
  and medical prescription.
• The dispense of the antibiotics must take place
  in the presence of a prescription.
• The condition of sale written in the package of
  each antibiotic pharmaceutical product must be
• executed in all circunstance and at any
  moment.(Document 4C/4619, September 1999)

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• Contents of the action plan
• Fulfilment of the antimicrobial sale restriction
  
• (sale only with prescription).
• Population Information leaflets and posters in
  community pharmacies.
• Extensive coverage on radio and television news.
• Education campaign.
• Test the compliance of the sale restriction.

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Results

• There was an important reduction in consumption,
  expressed as DDD/1000 inh.-day, after the
  introduction of the regulatory measures for the
  most oral antibiotic groups.
• There was also an important fall in sale units
  and also in sales expressed in US dollars, after
  1999.
• This tendency is mainteined during the last 3
  years.

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This is where a large graphic or chart can go.
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Graph 2Units of packages sold from 1988 to 2002.
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Graph 3Units of packages sold from 1988 to 2002.
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Table 1Sales of orals antibiotic in USD.(Mill)
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CONCLUSIONS

• The regulatory measures in 1999 had an
  important impact in the communitys antibiotic
• consumption in Chile.
• The regulatory measures contributed to a
• considerable saving of money in the community
  due to a decrease in antibiotic use.
• The success of the long term program depends
• on the compliance, maintenance, supervision
• and control of these measures by involved
• parts, including physicians, prescriptors,
• pharmacist and community in general.