title: Urinary antibiotic activity in paediatric patients attending an outpatient department in north-western Cambodia.
abstract: OBJECTIVE
  Antibiotic resistance is a prominent public and global health concern. We investigated antibiotic use in children by determining the proportion of unselected children with antibacterial activity in their urine attending a paediatric outpatient department in Siem Reap, Cambodia.
  
  
  METHODS
  Caregiver reports of medication history and presence of possible infection symptoms were collected in addition to urine samples. Urine antibiotic activity was estimated by exposing bacteria to urine specimens, including assessment against multiresistant bacteria previously isolated from patients in the hospital (a methicillin-resistant Staphylococcus aureus (MRSA), a multiresistant Salmonella typhi and an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolate).
  
  
  RESULTS
  Medication information and urine were collected from 775 children. Caregivers reported medication use in 69.0% of children in the preceding 48 h. 31.7% samples showed antibacterial activity; 16.3% showed activity against a local multiresistant organism. No specimens demonstrated activity against an ESBL-producing E. coli.
  
  
  CONCLUSIONS
  Antibiotics are widely used in the community setting in Cambodia. Parents are often ill-informed about drugs given to treat their children. Increasing the regulation and training of private pharmacies in Cambodia may be necessary. Regional surveillance of antibiotic use and resistance is also essential in devising preventive strategies against further development of antibiotic resistance, which would have both local and global consequences.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, UK.
authors.forename: Katherine R W
authors.initials: KR
authors.lastname: Emary
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Carter
authors.forename: Sreymom
authors.initials: S
authors.lastname: Pol
authors.forename: Soeng
authors.initials: S
authors.lastname: Sona
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
authors.forename: Catrin E
authors.initials: CE
authors.lastname: Moore
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000652:urine*; D002160:Cambodia; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D010045:Outpatients; D012485:Salmonella typhi / Q000187:drug effects; D014556:Urine / Q000737:chemistry*; D001618:beta-Lactamases / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: Antibióticos; Cambodge; Cambodia; Camboya; Pediátrico; antibiotics; antibiotiques; paediatric; pédiatriques