{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:22:58Z","timestamp":1779315778783,"version":"3.51.4"},"reference-count":39,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Rockefeller Foundation\u2013Boston University 3-D Commission","award":["2019 HTH 024"],"award-info":[{"award-number":["2019 HTH 024"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,10,5]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the antibiotic prescription rates for typhoid in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Private sector primary care clinicians in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The data came from prescriptions of a panel of 4600 private sector primary care clinicians selected through a multistage stratified random sampling accounting for the region, specialty type and patient turnover. The data had 671\u2009million prescriptions for antibiotics extracted from the IQVIA database for the years 2013, 2014 and 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Mean annual antibiotic prescription rates; sex-specific and age-specific prescription rates; distribution of antibiotic class.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 8.98\u2009million antibiotic prescriptions per year for typhoid, accounting for 714 prescriptions per 100\u2009000 population. Children 10\u201319 years of age represented 18.6% of the total burden in the country in absolute numbers, 20\u201329\u2009year age group had the highest age-specific rate, and males had a higher average rate (844\/100 000) compared with females (627\/100\u2009000). Ten different antibiotics accounted for 72.4% of all prescriptions. Cefixime\u2013ofloxacin combination was the preferred drug of choice for typhoid across all regions except the south. Combination antibiotics are the preferred choice of prescribers for adult patients, while cephalosporins are the preferred choice for children and young age. Quinolones were prescribed as monotherapy in 23.0% of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nationally representative private sector antibiotic prescription data during 2013\u20132015 indicate a higher disease burden of typhoid in India than previously estimated. The total prescription rate shows a declining trend. Young adult patients account for close to one-third of the cases and children less than 10 years account for more than a million cases annually.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-062401","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T11:20:43Z","timestamp":1666005643000},"page":"e062401","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Quantifying antibiotic use in typhoid fever in India: a cross-sectional analysis of private sector medical audit data, 2013\u20132015"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1220-5754","authenticated-orcid":false,"given":"Shaffi","family":"Fazaludeen Koya","sequence":"first","affiliation":[{"name":"Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habib","family":"Hasan Farooqui","sequence":"additional","affiliation":[{"name":"College of Medicine, Qatar University, Doha, Ad Dawhah, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4099-9915","authenticated-orcid":false,"given":"Aashna","family":"Mehta","sequence":"additional","affiliation":[{"name":"Health Economics, Financing and Policy Division, Public Health Foundation of India, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-1958","authenticated-orcid":false,"given":"Sakthivel","family":"Selvaraj","sequence":"additional","affiliation":[{"name":"Health Economics, Financing and Policy Division, Public Health Foundation of India, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Galea","sequence":"additional","affiliation":[{"name":"School of Public Health, Boston University, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"2025120518194467000_12.10.e062401.1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(18)30685-6"},{"key":"2025120518194467000_12.10.e062401.2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004616"},{"key":"2025120518194467000_12.10.e062401.3","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2552-1"},{"key":"2025120518194467000_12.10.e062401.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz611"},{"key":"2025120518194467000_12.10.e062401.5","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000479"},{"key":"2025120518194467000_12.10.e062401.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1111"},{"key":"2025120518194467000_12.10.e062401.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2016.08.002"},{"key":"2025120518194467000_12.10.e062401.8","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/S1473-3099(21)00627-7","article-title":"Estimating the effect of vaccination on antimicrobial-resistant typhoid fever in 73 countries supported by Gavi: a mathematical modelling study","volume":"22","author":"Birger","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2025120518194467000_12.10.e062401.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30259-6"},{"key":"2025120518194467000_12.10.e062401.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-019-4169-y","article-title":"Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data","volume":"19","author":"Arinaminpathy","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2025120518194467000_12.10.e062401.11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223097"},{"key":"2025120518194467000_12.10.e062401.12","unstructured":"India I . 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