Prevalence and correlates of antibiotic sharing in the Philippines: antibiotic misconceptions and community-level access to non-medical sources of antibiotics.

OBJECTIVE: To identify sociodemographic, knowledge and attitudinal correlates to antibiotic sharing among a community-based sample of adults (age 18 and older) in a low-income setting of the Philippines and to explore community-level data on informal antibiotic distribution in roadside stands (i.e., sari-sari stands). METHODS: Participants (n = 307) completed self-administered surveys. Correlates to antibiotic sharing were assessed using logistic regression with Firth's bias-adjusted estimates. Study staff also visited 106 roadside stands and collected data on availability and characteristics of antibiotics in the stands. RESULTS: 78% had shared antibiotics in their lifetime, most often with family members. In multivariable analysis, agreement with the belief that it is safe to prematurely stop an antibiotic course (OR: 2.8, CI: 1.3-5.8) and concerns about antibiotic side effects (OR: 2.1, CI: 1.1-4.4) were significantly associated with increased odds of reported antibiotic sharing. Antibiotic sharing was not associated with sociodemographic characteristics or antibiotic knowledge. Antibiotics were widely available in 60% of sampled sari-sari stands, in which 59% of antibiotics were missing expiration dates. Amoxicillin and cephalexin were the most commonly available antibiotics for sale at the stands (60% and 21%, respectively). CONCLUSIONS: Antibiotic sharing was common and was associated with misconceptions about proper antibiotic use. Antibiotics were widely available in sari-sari stands, and usually without expiration information. This study suggests that multipronged and locally tailored approaches to curbing informal antibiotic access are needed in the Philippines and similar Southeast-Asian countries.

DprA is required for natural transformation and affects pilin variation in Neisseria gonorrhoeae.

Natural transformation is the main means of horizontal genetic exchange in the obligate human pathogen Neisseria gonorrhoeae and drives the spread of antibiotic resistance and virulence determinants. Transformation can be divided into four steps: (1) DNA binding, (2) DNA uptake, (3) DNA processing and (4) DNA recombination into the chromosome. The DNA processing enzyme DprA has been shown to shuttle incoming ssDNA to the recombination enzyme RecA during transformation in Bacillus subtilis and Streptococcus pneumoniae. Here, we investigate the role of DprA during transformation in N. gonorrhoeae. Inactivation of dprA completely abrogated transformation of gyrB1-encoding DNA, which confers nalidixic acid resistance. The presence of the DNA uptake sequence enhances DNA uptake and transformation by binding to the minor pilus protein ComP. Loss of transformation in the dprA null mutants was independent of the DNA uptake sequence. DprA mutants exhibited increased RecA-dependent pilin variation suggesting that DprA affects pilin variation. Unlike the exquisite UV sensitivity of a recA mutant, inactivation of dprA did not affect survival following UV irradiation. These results demonstrate that DprA has a conserved function during transformation, and reveal additional effects of DprA in N. gonorrhoeae during pilin variation.

Tomorrow's house: solar housing in 1940s America.

In the years surrounding World War II, solar house heating was seen by many American architects, journal editors, and policymakers as a necessary component of the expansion into suburbia. As the technological and financial aspects of home ownership came to take on broad social implications, design strategies of architectural modernism--including the expansive use of glass, the open plan and façade, and the flexible roof line--were seen as a means to construct suburbs that were responsive to anticipated concerns over materials allocations, over energy-resource scarcity, and over the economic challenges to postwar growth. As this article demonstrates, experiments in passive solar house design were a prominent means for envisioning the suburbs as an opportunity for new kinds of building and new ways of living. The article documents these developments and places them in the context of related efforts to think about the future.