Antibiotic use and antibiotic resistance among pregnant women and children under 2 years of age Infections and Infestations Resistance to antibiotics
Conditions
Interventions
This study plans for 1-month intervention preparation in September 2020, followed by 3-month long intervention between October and December 2020. After completion of the intervention the research team
Sponsors
Karolinska Institute
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Pregnant women/mothers: 1. 3rd trimester on enrolment and who, after the enrolment, plan to stay in the area for the next 24 months 2. Whose infants are born during the study period 3. Willing to participate in the study Healthcare providers (HCPs): 1. All medical doctors, assistant doctors, midwives, nurses, pharmacists, assistant pharmacists at the Vientiane provincial hospital, district hospitals or health centres in Feuang or Vangvieng as well as pharmacists and assistant pharmacists at private pharmacies in these districts. 2. Some HCPs will be invited to participate in individual qualitative interviews: 2.1. Private providers (in private clinics and pharmacies) in the study area 2.2. Representatives from central level such as Ministry of Health, university and professional organizations 2.3. Providers from the public healthcare facilities involved 2.4. HCPs and policy makers from the Maternal and New-born Hospital (MNH) in Vientiane capital, where women from different parts of the country come for ANC and consultation
Exclusion criteria
Exclusion criteria: Does not meet inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of uncomplicated normal deliveries for which antibiotics were used measured using data on antibiotic use for each delivery collected continuously from patient records for 27 months: from 12 months before the intervention, during the intervention (3 months), and 12 months after the intervention. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Pregnant women and mothers' knowledge, attitudes, and reported practices regarding antibiotic use during pregnancy and for children and antibiotic resistance (ABR) measured using repeated structured interviews performed at 3 time points: before the intervention (during pregnancy and within the 6 months after delivery) and within the 6 months after the intervention 2. Perceptions of pregnant women and mothers regarding antibiotic use and resistance during pregnancy, delivery, and for children under two explored using focus group discussions at 2 time points: 1 year before and within 3 months after the intervention 3. Healthcare practitioners (HCPs) knowledge, attitudes and reported practices regarding antibiotic use for pregnant women, during delivery and for children and antibiotic resistance (ABR) measured using repeated structured interviews performed at 2 time points: 1 year to 6 months before, and within 6 months after the intervention 4. Perceptions of HCPs towards antibiotic administration to pregnant women, during delivery and for children under two explored using individual interviews at 2 time points: 1 year before and within 3 months after the intervention 5. The proportion of children under 2 years of age where antibiotics have been used measured using data on antibiotic use for children under 2 years of age measured using repeated structured interviews on mothers' knowledge, attitudes, and reported practices regarding antibiotic use for children and antibiotic resistance performed at 2 time points: within the 6 months after delivery and within the 6 months after the intervention 6. The proportion of samples with ESBL or multidrug-resistant producing bacteria and other relevant resistances pattern to tested antibiotics (only pre-intervention phase) measured using fecal samples collected from all pregnant women before delivery, during delivery from women and their newborn ch | — |
Countries
Laos
Outcome results
None listed