{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:31:38Z","timestamp":1787027498240,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["SLS-776141"],"award-info":[{"award-number":["SLS-776141"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"name":"InDevelops u-landsfond","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"publisher"}]},{"name":"R\u00f6nnows Foundation travel scholarships","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Antibiotic resistance is a naturally occurring phenomenon, but the misuse and overuse of antibiotics is accelerating the process. This study aimed to quantify and compare antibiotic use before, during, and after seeking outpatient care for acute febrile illness in Ujjain, India. Data were collected through interviews with patients\/patient attendants. The prevalence and choice of antibiotics is described by the WHO AWaRe categories and Anatomical Therapeutic Chemical classes, comparing between age groups. Units of measurement include courses, encounters, and Defined Daily Doses (DDDs). The antibiotic prescription during the outpatient visit was also described in relation to the patients\u2019 presumptive diagnosis. Of 1000 included patients, 31.1% (n = 311) received one antibiotic course, 8.1% (n = 81) two, 1.3% (n = 13) three, 0.4% (n = 4) four, 0.1% (n = 1) five, and the remaining 59.0% (n = 590) received no antibiotics. The leading contributors to the total antibiotic volume in the DDDs were macrolides (30.3%), combinations of penicillins, including \u03b2-lactamase inhibitors (18.8%), tetracyclines (14.8%), fluoroquinolones (14.6%), and third-generation cephalosporins (13.7%). \u2018Watch\u2019 antibiotics accounted for 72.3%, 52.7%, and 64.0% of encounters before, during, and after the outpatient visit, respectively. Acute viral illness accounted for almost half of the total DDDs at the outpatient visit (642.1\/1425.3, 45.1%), for which the macrolide antibiotic azithromycin was the most frequently prescribed antibiotic (261.3\/642.1, 40.7%).<\/jats:p>","DOI":"10.3390\/antibiotics11050574","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T21:16:28Z","timestamp":1650921388000},"page":"574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Antibiotic Use before, during, and after Seeking Care for Acute Febrile Illness at a Hospital Outpatient Department: A Cross-Sectional Study from Rural India"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-0572","authenticated-orcid":false,"given":"Bronwen","family":"Holloway","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University, 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshitha","family":"Chandrasekar","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University, 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Purohit","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, India"},{"name":"Department of Global Public Health, Health Systems and Policy, Karolinska Institute, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2404-9231","authenticated-orcid":false,"given":"Aditya","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"KC","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University, 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Fernandez-Carballo","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics, 1202 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Dittrich","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics, 1202 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Hildenwall","sequence":"additional","affiliation":[{"name":"Department of Global Public Health, Health Systems and Policy, Karolinska Institute, 171 77 Stockholm, Sweden"},{"name":"Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, 171 64 Solna, Sweden"},{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 52 Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bergstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University, 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Laxminarayan, R., and Chaudhury, R.R. 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