Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?

<h3>Background</h3><p dir="ltr">Recent research has indicated an increase in antibiotic utilisation, particularly pediatric formulations. Furthermore, an increasing trend in antimicrobial resistance rates has also been reported. Empirical evidence suggests that immunisati...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Habib Hasan Farooqui (7861166) (author)
مؤلفون آخرون: Anup Karan (444710) (author), Aashna Mehta (2136571) (author), Giridhara Rathnaiah Babu (17933762) (author), Onno C. P. van Schayck (7594037) (author)
منشور في: 2025
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author Habib Hasan Farooqui (7861166)
author2 Anup Karan (444710)
Aashna Mehta (2136571)
Giridhara Rathnaiah Babu (17933762)
Onno C. P. van Schayck (7594037)
author2_role author
author
author
author
author_facet Habib Hasan Farooqui (7861166)
Anup Karan (444710)
Aashna Mehta (2136571)
Giridhara Rathnaiah Babu (17933762)
Onno C. P. van Schayck (7594037)
author_role author
dc.creator.none.fl_str_mv Habib Hasan Farooqui (7861166)
Anup Karan (444710)
Aashna Mehta (2136571)
Giridhara Rathnaiah Babu (17933762)
Onno C. P. van Schayck (7594037)
dc.date.none.fl_str_mv 2025-05-24T09:00:00Z
dc.identifier.none.fl_str_mv 10.1186/s12879-025-11082-3
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Did_the_periodic_intensification_of_routine_immunisation_strategy_Intensified_mission_Indradhanush_reduce_the_demand_for_pediatric_antibiotic_formulations_in_India_/30393256
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
India
Antibiotic utilisation
Immunisation
Intensified mission
Indradhanush
Interrupted time series
dc.title.none.fl_str_mv Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Recent research has indicated an increase in antibiotic utilisation, particularly pediatric formulations. Furthermore, an increasing trend in antimicrobial resistance rates has also been reported. Empirical evidence suggests that immunisation reduces the demand for antibiotics. We examined the potential impact of the periodic intensification of the routine immunisation strategy - Intensified Mission Indradhanush (IMI), which was implemented from October 2017 to January 2018, on antibiotic utilisation in India.</p><h3>Methods</h3><p dir="ltr">We analysed the PharmaTrac dataset to assess the impact of IMI on antibiotic utilisation. We conducted interrupted time series analyses by fitting a Poisson regression model. We used Newey–West standard errors to account for autocorrelation and heteroskedasticity.</p><h3>Findings</h3><p dir="ltr">Poisson segmented regression analysis showed a 12.6% decrease in Fluoroquinolones sales in the first month of IMI implementation (incidence rate ratio [IRR] 0.874, 95%CI: 0.777–0.983). However, post-intervention, their sales remained broadly constant (IRR 1.000, 95%CI 0.995–1.006). Similarly, Chloramphenicol sales decreased by 0.6% in the first month, whereas sales increased by a trend of 0.4% per month (IRR 1.004, 95%CI 0.991–1.017) post-intervention. Interestingly, Trimethoprim sales increased by 17.1% in the first month but decreased by 0.4% per month (IRR 0.959, 95%CI 0.945–0.973) post-intervention. However, there was a modest increase in sales of Macrolides by 3.0%, Cephalosporins by 2.9% and broad-spectrum Penicillin by 0.2% in the first month. Thereafter, Macrolides sales increased by a monthly rate of 0.5% (IRR 1.005, 95% CI 1.000–1.010), Cephalosporins increased by 0.5% (IRR 1.005, 95% CI 1.000 -1.010) and Broad spectrum penicillin increased by 0.9% (IRR 1.009, 95% CI 1.004–1.013) in the post-intervention period. Furthermore, there were heterogeneities across Indian states.</p><h3>Interpretation</h3><p dir="ltr">The IMI’s impact on antibiotic utilisation was heterogeneous across antibiotic classes and Indian states.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Infectious Diseases<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12879-025-11082-3" target="_blank">https://dx.doi.org/10.1186/s12879-025-11082-3</a></p>
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spelling Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?Habib Hasan Farooqui (7861166)Anup Karan (444710)Aashna Mehta (2136571)Giridhara Rathnaiah Babu (17933762)Onno C. P. van Schayck (7594037)Biomedical and clinical sciencesPharmacology and pharmaceutical sciencesHealth sciencesEpidemiologyIndiaAntibiotic utilisationImmunisationIntensified missionIndradhanushInterrupted time series<h3>Background</h3><p dir="ltr">Recent research has indicated an increase in antibiotic utilisation, particularly pediatric formulations. Furthermore, an increasing trend in antimicrobial resistance rates has also been reported. Empirical evidence suggests that immunisation reduces the demand for antibiotics. We examined the potential impact of the periodic intensification of the routine immunisation strategy - Intensified Mission Indradhanush (IMI), which was implemented from October 2017 to January 2018, on antibiotic utilisation in India.</p><h3>Methods</h3><p dir="ltr">We analysed the PharmaTrac dataset to assess the impact of IMI on antibiotic utilisation. We conducted interrupted time series analyses by fitting a Poisson regression model. We used Newey–West standard errors to account for autocorrelation and heteroskedasticity.</p><h3>Findings</h3><p dir="ltr">Poisson segmented regression analysis showed a 12.6% decrease in Fluoroquinolones sales in the first month of IMI implementation (incidence rate ratio [IRR] 0.874, 95%CI: 0.777–0.983). However, post-intervention, their sales remained broadly constant (IRR 1.000, 95%CI 0.995–1.006). Similarly, Chloramphenicol sales decreased by 0.6% in the first month, whereas sales increased by a trend of 0.4% per month (IRR 1.004, 95%CI 0.991–1.017) post-intervention. Interestingly, Trimethoprim sales increased by 17.1% in the first month but decreased by 0.4% per month (IRR 0.959, 95%CI 0.945–0.973) post-intervention. However, there was a modest increase in sales of Macrolides by 3.0%, Cephalosporins by 2.9% and broad-spectrum Penicillin by 0.2% in the first month. Thereafter, Macrolides sales increased by a monthly rate of 0.5% (IRR 1.005, 95% CI 1.000–1.010), Cephalosporins increased by 0.5% (IRR 1.005, 95% CI 1.000 -1.010) and Broad spectrum penicillin increased by 0.9% (IRR 1.009, 95% CI 1.004–1.013) in the post-intervention period. Furthermore, there were heterogeneities across Indian states.</p><h3>Interpretation</h3><p dir="ltr">The IMI’s impact on antibiotic utilisation was heterogeneous across antibiotic classes and Indian states.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Infectious Diseases<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12879-025-11082-3" target="_blank">https://dx.doi.org/10.1186/s12879-025-11082-3</a></p>2025-05-24T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12879-025-11082-3https://figshare.com/articles/journal_contribution/Did_the_periodic_intensification_of_routine_immunisation_strategy_Intensified_mission_Indradhanush_reduce_the_demand_for_pediatric_antibiotic_formulations_in_India_/30393256CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/303932562025-05-24T09:00:00Z
spellingShingle Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
Habib Hasan Farooqui (7861166)
Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
India
Antibiotic utilisation
Immunisation
Intensified mission
Indradhanush
Interrupted time series
status_str publishedVersion
title Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
title_full Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
title_fullStr Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
title_full_unstemmed Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
title_short Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
title_sort Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?
topic Biomedical and clinical sciences
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
India
Antibiotic utilisation
Immunisation
Intensified mission
Indradhanush
Interrupted time series