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    Pathways to optimising antibiotic use in rural China: Identifying key determinants in community and clinical settings, a mixed methods study protocol

    Date
    2019-08-10
    Author
    Zhao, Linhai
    Kwiatkowska, Rachel Marie
    Chai, Jing
    Cabral, Christie
    Chen, Meixuan
    Bowker, Karen
    Coope, Caroline
    Shen, Jilu
    Shen, XingRong
    Cheng, Jing
    Feng, Rui
    Kadetz, Paul
    MacGowan, Alasdair
    Oliver, Isabel
    Hickman, Matthew
    Wang, Debin
    Lambert, Helen
    Metadata
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    Citation
    Zhao, L., Kwiatkowska, R.M., Chai, J., Cabral, C., Chen, M., Bowker, K., Coope, C., Shen, J., Shen, X., Cheng, J., Feng, R., Kadetz, P., MacGowan, A., Oliver, I., Hickman, M., Wang, D. and Lambert, H. (2019) ‘Pathways to optimising antibiotic use in rural China: Identifying key determinants in community and clinical settings, a mixed methods study protocol’, BMJ Open, 9(8), article no. e027819.
    Abstract
    Introduction This study aims to investigate patterns of antibiotic treatment-seeking, describe current levels of and drivers for antibiotic use for common infections (respiratory tract and urinary tract infections) and test the feasibility of determining the prevalence and epidemiology of antimicrobial resistance (AMR) in rural areas of Anhui province, in order to identify potential interventions to promote antibiotic stewardship and reduce the burden of AMR in China. Methods and analysis We will conduct direct observations, structured and semistructured interviews in retail pharmacies, village clinics and township health centres to investigate treatment-seeking and antibiotic use. Clinical isolates from 1550 sputum, throat swab and urine samples taken from consenting patients at village and township health centres will be analysed to identify bacterial pathogens and ascertain antibiotic susceptibilities. Healthcare records will be surveyed for a subsample of those recruited to the study to assess their completeness and accuracy. Ethics and dissemination The full research protocol has been reviewed and approved by the Biomedical Ethics Committee of Anhui Medical University (reference number: 20170271). Participation of patients and doctors is voluntary and written informed consent is sought from all participants. Findings from the study will be disseminated through academic routes including peerreviewed publications and conference presentations, via tailored research summaries for health professionals, health service managers and policymakers and through an end of project impact workshop with local and regional stakeholders to identify key messages and priorities for action.
    Official URL
    http://dx.doi.org/10.1136/bmjopen-2018-027819
    URI
    https://eresearch.qmu.ac.uk/handle/20.500.12289/12389
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