{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:24:30Z","timestamp":1788852270248,"version":"build-2803163510"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:p>Mass drug administration (MDA) for trachoma control using azithromycin has generated concern for the development of resistant organisms. However, the contribution from azithromycin available in local pharmacies has not been studied. In Kilosa district, Tanzania, MDA stopped over 4 years ago, and this study sought to determine the availability of azithromycin in local pharmacies and correlate it with azithromycin resistance in children born after MDA. A cross-sectional survey was conducted in 644 randomly selected hamlets in Kilosa district, in which the presence of a pharmacy and the availability of azithromycin and erythromycin were determined. In 30 randomly selected hamlets, a random sample of 60 children less than 5 years were tested for azithromycin-resistant <jats:italic>Streptococcus pneumoniae<\/jats:italic> (<jats:italic>Spn<\/jats:italic>) and <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>Ec<\/jats:italic>), from nasopharyngeal and rectal swabs, based on disk diffusion criteria. Only 26.6% of hamlets had a pharmacy. Azithromycin and erythromycin were available in 30.8% and 89.1% of pharmacies closest to the hamlets, respectively. In the 30 communities tested for resistance, the overall prevalence of azithromycin-resistant <jats:italic>Spn<\/jats:italic> isolates was 14%. Six of seven (87%) hamlets where azithromycin was available had resistant <jats:italic>Spn,<\/jats:italic> compared with 14 of 23 (61%) hamlets without availability. Similarly, six of seven (87%) hamlets where azithromycin was available had resistant <jats:italic>Ec<\/jats:italic> isolates compared with 21 of 23 (70%) hamlets without availability. However, the differences were not statistically significant (<jats:italic>P<\/jats:italic> = 0.46 and 0.49, respectively). The availability of azithromycin in pharmacies in the district was limited, and a strong correlation with azithromycin-resistant <jats:italic>Spn<\/jats:italic> or <jats:italic>Ec<\/jats:italic> was not observed.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0747","type":"journal-article","created":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T07:00:49Z","timestamp":1553583649000},"page":"1105-1109","source":"Crossref","is-referenced-by-count":7,"title":["A Cross-Sectional Study of the Availability of Azithromycin in Local Pharmacies and Associated Antibiotic Resistance in Communities in Kilosa District, Tanzania"],"prefix":"10.4269","volume":"100","author":[{"given":"Derick","family":"Ansah","sequence":"first","affiliation":[{"name":"Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerusha","family":"Weaver","sequence":"additional","affiliation":[{"name":"Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Munoz","sequence":"additional","affiliation":[{"name":"Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian L.","family":"Coles","sequence":"additional","affiliation":[{"name":"Uniformed Services University of Health Sciences, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lietman","sequence":"additional","affiliation":[{"name":"Proctor Foundation, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila K.","family":"West","sequence":"additional","affiliation":[{"name":"Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0004352","article-title":"Can we use antibodies to Chlamydia trachomatis as a surveillance tool for National Trachoma Control Programs? 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