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Статті в журналах з теми "Non-prescribed antibiotics"
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Torres, `Neusa, Vernon Solomon, and Lyn Middleton. "Pharmacists’ practices for non-prescribed antibiotic dispensing in Mozambique." Pharmacy Practice 18, no. 3 (August 18, 2020): 1965. http://dx.doi.org/10.18549/pharmpract.2020.3.1965.
Повний текст джерелаАнотація:
Background: Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance.
Objective: We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique.
Methods: A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed.
Results: Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients’ behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians’ prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms.
Conclusions: The practices of non-prescribed antibiotic dispensing characterize the ‘daily life’ of the pharmacists. On the one hand, the patient’s demand for antibiotics without valid prescriptions, and pharmacist’s wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique.
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Hu, Jie, and Zhiqiang Wang. "Non-prescribed antibiotic use and general practitioner service utilisation among Chinese migrants in Australia." Australian Journal of Primary Health 22, no. 5 (2016): 434. http://dx.doi.org/10.1071/py15076.
Повний текст джерелаАнотація:
Non-prescribed antibiotic use occurs worldwide and is an important contributor to antibiotic resistance. Social and health system factors were related to the practice of self-medication with antibiotics. This study aims to investigate the practice of non-prescribed antibiotic use, and to assess the impact of primary health service access and use on this practice among Australian Chinese migrants. Four-hundred and twenty-six participants, who self-identified as Chinese and who had been residing in Australia for at least 12 months, were recruited through several Australian Chinese social websites to participate in an online health survey about antibiotic use and health services use from July to October 2013. Logistic regression analyses were conducted to assess the associations between health services utilisation factors and the use of non-prescribed antibiotics. In total, 20.2% (86/426) participants reported having used antibiotics without medical consultation in the last 12 months. Of 170 antibiotic users, 50.6% (86/170) used antibiotics without medical consultation. Chinese migrants who self-evaluated as ‘satisfied’ with the experiences of GP services were less likely to self-medicate with antibiotics. In addition, Chinese migrants without any perceived barriers to using primary health services in Australia were less likely to use non-prescribed antibiotics. Among Australian Chinese migrants, over half of antibiotic users admitted that they had used antibiotics without medical consultation. Participants with positive experience and perception of primary health services, primarily GP services, had a lower risk of using non-prescribed antibiotics.
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Wang, Nan Christine. "Pre-Visit Use of Non-Prescribed Antibiotics among Child Patients in China: Prevalence, Predictors, and Association with Physicians’ Prescribing of Antibiotics at Medical Visits." Antibiotics 11, no. 11 (November 4, 2022): 1553. http://dx.doi.org/10.3390/antibiotics11111553.
Повний текст джерелаАнотація:
Antibiotic resistance is one of the most serious global public health crises. Inappropriate use of antibiotics is an important contributor. Using a cross-sectional survey, we recruited 3056 caregivers from 21 provinces in China to complete a questionnaire pertaining to their most recent medical visits for children’s acute respiratory tract infection (ARTI) symptoms in October 2013. The findings show that the prevalence of caregivers giving children non-prescribed antibiotics before their medical visit was as high as 38%. Caring for an older child and having lower educational attainment increased the likelihood of self-medication with antibiotics; among Chinese residential areas, caregivers living in tier 2 urban districts were most likely to administer non-prescribed antibiotics before their visit. Physicians’ prescribing of antibiotics was significantly associated with caregivers’ self-reported pre-visit use of non-prescribed antibiotics. Misuse should be addressed by regulating the sale of antibiotics and improving communication at medical consultations.
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Machowska, Anna, Kristoffer Landstedt, Cecilia Stålsby Lundborg, and Megha Sharma. "Antibiotic Prescribing to Patients with Infectious and Non-Infectious Indications Admitted to Obstetrics and Gynaecology Departments in Two Tertiary Care Hospitals in Central India." Antibiotics 9, no. 8 (July 30, 2020): 464. http://dx.doi.org/10.3390/antibiotics9080464.
Повний текст джерелаАнотація:
Background: Patients admitted to obstetrics and gynaecology (OBGY) departments are at high risk of infections and subsequent antibiotic prescribing, which may contribute to antibiotic resistance (ABR). Although antibiotic surveillance is one of the cornerstones to combat ABR, it is rarely performed in low- and middle-income countries. Aim: To describe and compare antibiotic prescription patterns among the inpatients in OBGY departments of two tertiary care hospitals, one teaching (TH) and one nonteaching (NTH), in Central India. Methods: Data on patients’ demographics, diagnoses and prescribed antibiotics were collected prospectively for three years. Patients were divided into two categories- infectious and non-infectious diagnosis and were further divided into three groups: surgical, nonsurgical and possible-surgical indications. The data was coded based on the Anatomical Therapeutic Chemical classification system, and the International Classification of Disease system version-10 and Defined Daily Doses (DDDs) were calculated per 1000 patients. Results: In total, 5558 patients were included in the study, of those, 81% in the TH and 85% in the NTH received antibiotics (p < 0.001). Antibiotics were prescribed frequently to the inpatients in the nonsurgical group without any documented bacterial infection (TH-71%; NTH-75%). Prescribing of broad-spectrum, fixed-dose combinations (FDCs) of antibiotics was more common in both categories in the NTH than in the TH. Overall, higher DDD/1000 patients were prescribed in the TH in both categories. Conclusions: Antibiotics were frequently prescribed to the patients with no documented infectious indications. Misprescribing of the broad-spectrum FDCs of antibiotics and unindicated prescribing of antibiotics point towards threat of ABR and needs urgent action. Antibiotics prescribed to the inpatients having nonbacterial infection indications is another point of concern that requires action. Investigation of underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve antibiotic prescribing practice.
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Silfwerbrand, Elisabeth, Sumeer Verma, Cora Sjökvist, Cecilia Stålsby Lundborg, and Megha Sharma. "Diagnose-Specific Antibiotic Prescribing Patterns at Otorhinolaryngology Inpatient Departments of Two Private Sector Healthcare Facilities in Central India: A Five-Year Observational Study." International Journal of Environmental Research and Public Health 16, no. 21 (October 23, 2019): 4074. http://dx.doi.org/10.3390/ijerph16214074.
Повний текст джерелаАнотація:
Antibiotics are over-prescribed in low-and-middle-income countries, where the infection rate is high. The global paucity of standard treatment guidelines and reliable diagnose-specific prescription data from high-infection risk departments such as the otorhinolaryngology (ENT: ears, nose and throat) is a barrier to rationalize antibiotic use and combat antibiotic resistance. The study was conducted to present diagnose-specific antibiotic prescribing patterns of five years at ENT inpatient departments of two private-sector Indian hospitals. Data of all consecutive inpatients (n = 3527) were collected but analyzed for the inpatients aged >15 years (n = 2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses groups: surgical, non-surgical, chronic suppurative otitis media (CSOM), and others. Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% of patients in the clean surgery group and more than 75% in the viral and non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis (31%), where 90% of inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. This study highlights the inappropriate prescribing of antibiotics to patients of clean surgeries, viral infections, and non-infectious groups. The single-prophylactic dose of antibiotic for clean-contaminated surgeries was replaced by the prolonged empirical prescribing. The use of microbiology investigations was insignificant.
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Linder, Jeffrey A., Tiffany Brown, Ji Young Lee, Kao-Ping Chua, and Michael A. Fischer. "1632. Non-Visit-Based and Non-Infection-Related Ambulatory Antibiotic Prescribing." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S43. http://dx.doi.org/10.1093/ofid/ofy209.102.
Повний текст джерелаАнотація:
Abstract Background Many studies have examined or intervened on ambulatory antibiotic prescribing based on infection-related diagnosis codes. However, clinicians may prescribe antibiotics without seeing patients face-to-face or without documenting an infection-related diagnosis. Methods We measured the prevalence of non-visit-based and non-infection-related oral, antibacterial–antibiotic prescribing between November 2015 and October 2017 using the EHR of an integrated health delivery system. We examined the visit type (in-person vs. other) and classified prescriptions into 3 mutually exclusive groups based on same-day diagnosis codes: (1) infection-related for prescriptions associated with at least one of 21,730 ICD-10 codes that may signify infection; (2) non-infection-related for prescriptions only associated with the 72,519 ICD-10 codes that do not signify infections; and (3) associated with no diagnosis. Results There were 509,534 antibiotic prescriptions made to 279,169 unique patients by 2,413 clinicians in 514 clinics. Patients had a mean age of 43 years old, were 60% women, and 75% white. Clinicians were 54% women; were 63% attending physicians, 18% residents/fellows, 10% nurse practitioners, and 7% physician assistants; and were 41% medical specialists, 21% primary care clinicians, and 7% surgical specialists. The most common antibiotic classes were penicillins (30%), macrolides (23%), cephalosporins (14%), fluoroquinolones (11%), tetracyclines (10%), and sulfonamides (6%). Clinicians prescribed 20% of antibiotics outside of an in-person visit; prescription encounters were in-person (80%), telephone (10%), order-only (4%), refill (4%), and online portal (1%). Clinicians prescribed 46% of antibiotics without an infection-related diagnosis: 54% of antibiotic prescriptions were infection-related, 29% were non-infection-related, and 17% were associated with no diagnosis. Various look-back and look-forward durations for diagnosis codes changed the results only slightly. Conclusion Clinicians prescribed 20% of antibiotics outside of in-person visits and 46% of antibiotics without an infection-related diagnosis. Interventions that target visit-based, diagnosis-specific prescriptions miss a large share of antibiotic prescribing. Disclosures All authors: No reported disclosures.
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Ajie, Anita Ayu Dwi, Retnosari Andrajati, and Maksum Radji. "FACTORS AFFECTING THE SALE OF NON-PRESCRIBED ANTIBIOTICS IN JAKARTA, INDONESIA: A CROSS-SECTIONAL STUDY." International Journal of Applied Pharmaceutics 10, no. 1 (December 20, 2018): 243. http://dx.doi.org/10.22159/ijap.2018.v10s1.54.
Повний текст джерелаАнотація:
Objective: This study aimed to investigate the factors affecting the sale of non-prescribed antibiotics in Jakarta, Indonesia.Methods: A cross-sectional, observational study was conducted across 190 randomly selected pharmacies in five administrative districts of Jakarta,Indonesia. Data regarding pharmacies were obtained from the Facility of Pharmaceutical Services Ministry of Health Data, in 2014, which includes allpharmacies in Jakarta. Further data were obtained using structured questionnaires.Results: Among the 190 respondents, 15 pharmacies (9.7%) never provided antibiotics without prescription, whereas 44 (23.6%), 60 (31.6%), and71 pharmacies (36.3%) provided antibiotic services without prescription rarely, sometimes, and always, respectively. Factors considerably associatedwith the increased sale of antibiotics without a prescription included the attitude and age of pharmacists, the type of pharmacy (independent or chainstore), and the presence of pharmacist assistants. Attitude was the most common variable related to providing antibiotics without a prescription.Conclusion: Antibiotics are frequently dispensed by community pharmacies in Jakarta without an appropriate prescription. These findings supportthe need for strict enforcement of pharmacy laws through improved inspections, and they highlight the need for evidence-based guidelines andeducational interventions to improve practices regarding antibiotic provision.
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Ishibashi, Noriomi, Ines Pauwels, Yuki Tomori, Yoshiaki Gu, Takefumi Yamaguchi, Takahiro Handa, Minoru Yamaoka, et al. "Point Prevalence Surveys of Antimicrobial Prescribing in a Non-Acute Care Hospital in Saitama Prefecture, Japan." Canadian Journal of Infectious Diseases and Medical Microbiology 2022 (March 25, 2022): 1–7. http://dx.doi.org/10.1155/2022/2497869.
Повний текст джерелаАнотація:
Background. The global point prevalence survey (Global-PPS) is the standard for the surveillance of prescribed antimicrobials among inpatients and provides data for the development of hospital antimicrobial stewardship programs. Aim. To evaluate the prevalence and quality of antimicrobial prescriptions using the universally standardized Global-PPS protocol in a non-acute care hospital in Saitama Prefecture, Japan. Methods. Antimicrobial prescriptions for inpatients, staying at the hospital overnight, were surveyed on three separate week days in November 2018, January 2019, and May 2019. Information on the prescribed antimicrobials on the survey target day was obtained from the in-hospital pharmacy. Survey data were collected by physicians, based on the extracted information. Patient information was anonymized and entered in the Global-PPS Web application by physicians. We report the antimicrobial use prevalence, the indication for prescription, diagnosis, the most prescribed antimicrobials, and a set of quality indicators related to antimicrobial prescribing. Results. In total, 6.7% of the surveyed inpatients (120/1796) were prescribed antimicrobials on the survey day. Sulfamethoxazole/trimethoprim was the most commonly prescribed, with 20.0% of systemic antibiotic prescriptions (ATC J01). Of all antibiotics for systemic use, up to 58.4% were Watch antibiotics, as defined by the World Health Organization AWaRe classification. The most prescribed group of systemic antibiotics was non-penicillin beta-lactam antibiotics (34.4%), followed by penicillin antibiotics in combination with beta-lactamase inhibitors (25.6%), and sulfonamides with trimethoprim (20.8%). Healthcare-associated infections and medical prophylaxis were the most common indications reported in 69.3% and 26.3% of prescriptions, respectively. The most common diagnosis for systemic antibiotic prescriptions was pneumonia (49.6%). Reasons for antimicrobial prescriptions were indicated in the medical records for 67.1% of prescriptions, and the stop/review date was documented to be 50.3%. Compliance with local guidelines reached 66.7%. Conclusions. This study highlights important challenges related to antimicrobial prescription in a highly specific, non-acute care patient population.
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Majid Aziz, Muhammad, Fatima Haider, Muhammad Fawad Rasool, Furqan Khurshid Hashmi, Sadia Bahsir, Pengchao Li, Mingyue Zhao, Thamir M. Alshammary, and Yu Fang. "Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion." Antibiotics 10, no. 5 (April 22, 2021): 482. http://dx.doi.org/10.3390/antibiotics10050482.
Повний текст джерелаАнотація:
Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated bilingual questionnaire was used, and we used chi-square tests in the statistical analysis. A total of 573 (91.7%) pharmacy retailers responded to the survey; 44.0% were aged 31–40 years and all were men. Approximately 81.5% of participants declared that dispensing non-prescribed antibiotics is a common practice in community pharmacies, and 51.1% considered themselves to be authorized to dispense these drugs; 69.3% believed this a contributing factor to antimicrobial resistance. Most (79.1%) respondents believed that this practice promotes irrational antibiotics use, and half (52.2%) considered antimicrobial resistance to be a public health issue. Only 34.5% of respondents reported recommending that patients consult with a doctor prior to using antibiotics, and 61.8% perceived that their dispensing practices reduce patients’ economic burden. Approximately 44.9% of pharmacy retailers stated that they have proper knowledge about antibiotics use. Nitroimidazole was the main class of antibiotic dispensed without a prescription. Dispensing of injectable and broad-spectrum antibiotics can be potential threat for infection cure. Poor knowledge of staff is associated with dispensing of non-prescribed antibiotics. This inappropriate practice must be addressed immediately.
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Okoro, Roland Nnaemeka, Chijioke Nmeka, and Patrick O. Erah. "Antibiotics prescription pattern and determinants of utilization in the national health insurance scheme at a Tertiary Hospital in Nigeria." African Health Sciences 19, no. 3 (November 4, 2019): 2356–64. http://dx.doi.org/10.4314/ahs.v19i3.8.
Повний текст джерелаАнотація:
Background: Subsidizing the cost of medicines through insurance schemes increases consumption of medicines and may contribute to irrational use of antibiotics. Objectives: To describe the systemic antibiotics prescriptions patterns and analyze the determinants of their utilization in the National Health insurance Scheme (NHIS).Methods: Established WHO guideline was followed to conduct this cross-sectional retrospective study at University of Nigeria Teaching Hospital, Nigeria. Data were collected from randomly sampled prescription sheets of one year duration. Logistic regression analysis was performed to determine the predictors of antibiotics prescriptions.Results: The results are based on 802 sampled out-patients NHIS prescriptions. Average number of medicines per encounter was 4.0 ± 1.8, whereas 46.9% of antibiotics were prescribed by generic name. Penicillins (most frequently amoxicillin/clavulanate), and nitroimidazole (most frequently metronidazole) were the most commonly prescribed antibiotics with percentage share of 43.3% and 22.2%. Being <5 years old, and taking more than 4 medicines (OR 2.20, 95% CI 1.37-3.55) were the factors associated with the highest risk of antibiotics exposure.Conclusion: There were poly-pharmacy, and non-adherence to generic antibiotic prescriptions. Penicillins (amoxicillin/clavulanate) were the most commonly prescribed antibiotic class. Being < 5 years old, and taking more than 4 medicines were significant predictors of antibiotics exposure.Keywords: Antibiotics; national health insurance scheme; Nigeria; poly-pharmacy; prescription.
Дисертації з теми "Non-prescribed antibiotics"
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Widayati, Aris. "Self medication with antibiotics in Yogyakarta City Indonesia." Thesis, 2013. http://hdl.handle.net/2440/83586.
Повний текст джерелаАнотація:
In Indonesia, legislation mandates a medical prescription for purchase of antibiotics. However, people can, in fact, purchase antibiotics without prescription which may be used inappropriately. Therefore, a comprehensive understanding of why people self medicate with antibiotics is essential to develop intervention programs for improving the safe use of antibiotics in the community. The aims of the research were to identify the prevalence and patterns of self medication with antibiotics (SMA) in Yogyakarta City Indonesia; to explore individuals’ knowledge and beliefs about antibiotics; to identify factors that influence individuals’ intentions to SMA; to explore underlying reasons of why individuals self medicate with antibiotics; and to explore stakeholders’ perspectives about how to improve the safe use of antibiotics in the community. The research applied a mixed-method approach and involved adults (over 18 years) of Yogyakarta City, Indonesia. The theory of planned behaviour (TPB) was applied as a conceptual framework to assist in identifying psychological factors associated with SMA at the individual level i.e. attitudes, subjective norms, and perceived behavioural control. The research was initiated by interviews with 25 participants to explore common beliefs about SMA practice among Indonesians. The interviews were informed by the TPB. Results of the interviews were used to structure TPB questions for a population-based survey. The survey had a sample size of 625 adults and applied a cluster random sampling technique. Following the survey, in-depth interviews with a group of the respondents in the survey, who had experience in using antibiotics for self medication, were conducted to explore underlying reasons of SMA practice. The overall results were then discussed with a group of stakeholders in Yogyakarta Province to formulate recommendations on how to improve the safe use of antibiotics in the community. The methods described above were approved by the Human Research Ethics Committee (HREC) at the University of Adelaide and the City Government of Yogyakarta Indonesia. A range of beliefs about SMA practice is highlighted through the interviews includes advantages, disadvantages, approvals, disapprovals, facilitators and barriers of such practice. The survey results in a 90% of response rate and 7.3% period prevalence of SMA. Although information and advice about antibiotics are mainly derived from doctors and pharmacists, the patterns of SMA indicate that antibiotics are used inappropriately. Misconceptions about antibiotic use also exist. Most of the survey respondents are aware of the disadvantages of SMA; and therefore, they are not in favour of practicing SMA. They also reported pressures from their social networks to not practice SMA, and noted that practicing SMA is not easy. However, experience in using antibiotics and the ease of obtaining antibiotics without prescription make the practice of SMA easier. To reduce SMA practice it is required to increase the provision of accurate information about antibiotics especially for improving people’s awareness regarding the risks of using antibiotics inappropriately. It is imperative to improve antibiotic prescription policy and to optimize the role of health professionals especially in providing reliable advice about antibiotics. It is also urgent to decrease access to antibiotics without prescription.Thesis (Ph.D.) -- University of Adelaide, School of Population Health, 2013
Книги з теми "Non-prescribed antibiotics"
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Prather, Christina, Mariatu Koroma-Nelson, and Mikhail Kogan. Common Geriatric Infections. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190466268.003.0017.
Повний текст джерелаАнотація:
The function of the immune system changes with aging. Immune support can decrease the risk of infection, are imperative practices to incorporate in the care of older adults. The most common infections among older adults are pneumonia and urinary tract infection (UTI). Infections in older person often associated with substantial morbidity and mortality. Antibiotics are commonly prescribed for variety of infections, however, often these can lead to severe complications such as infectious diarrhea. Integrative methods of managing non-life threatening infections reviewed in this chapter. In addition, this chapter details different ways of maintaining healthy immune function in older patient.
Тези доповідей конференцій з теми "Non-prescribed antibiotics"
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Khudadad, Hanan, and Lukman Thalib. "Antibiotics Prescription Patterns in Primary Health Care in Qatar – A Population based study from 2017 to 2018." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0169.
Повний текст джерелаАнотація:
Background: Antibiotics are antimicrobial drugs used in the treatment and prevention of bacterial infections. They played a pivotal role in achieving major advances in medicine and surgery (1). Yet, due to increased and inappropriate use of antibiotics, antibiotic resistance (AR) has become a growing public health problem. Information on antibiotic prescription patterns are vital in developing a constructive approach to deal with growing antibiotic resistance (2). The study aims to describe the population based antibiotic prescriptions among patients attending primary care centers in Qatar. Methodology: A population based observational study of all medications prescribed in the all Primary Health Care Centers during the period of 2017-2018 in Qatar. Records with all medication prescriptions were extracted and linked to medical diagnosis. Antibiotics prescriptions records were compared to non- antibiotics records using logistic regression model in identifying the potential predictors for antibiotic prescriptions. Results: A total of 11,069,439 medication prescriptions given over a period of two-years, we found about 12.1% (n= 726,667) antibiotics prescriptions were antibiotics, and 65% of antibiotics are prescribed and received by the patients at the first visits. Paracetamol (22.3%) was the first highest medication prescribed followed by antibiotics (12.1 %) and vitamin D2 (10.2 %). More than half of all antibiotics prescribed during the period of January 2017 to December 2018 were Penicillin (56.9%). We found that half of the antibiotics (49.3 %) have been prescribed for the respiratory system comparing to the other body system. We found that males were 29% more likely be given an antibiotic compared to females (OR=1.29, 95% CI= 1.24- 1.33). Implications: The study provides a baseline data to enable PHCC management to design effective intervention program to address the problem of antibiotics resistance. Furthermore, it will help the policymakers to comprehend the size of the issue and develop a system to manage the antibiotics therapy. Conclusion: Antibiotics was the second highest medication prescribed in the Primary Health Care Centers in Qatar after paracetamol and most of the patients received it at the first visit. Most of the prescriptions in Primary Health Care Centers in Qatar were for the respiratory system, and Penicillin was the highest class prescribed. Male visitors were prescribed antibiotics more than female visitors.
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Arora, Rahul D. "Inpatient pharmacologic management of malignant bowel obstruction." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685360.
Повний текст джерелаАнотація:
Background: Management of life threatening complications encountered in Advanced Cancer is an important domain of Palliative Oncology. Malignant Bowel Obstruction is usually an indicator of poor prognosis in Advanced cancer. It is usually associated with malignancies in the gastrointestinal tract or those outside the gastrointestinal tract (gynaecological malignancies). MBO can also occur with primary peritoneal as well as secondary peritoneal malignancies. Diagnostic criteria for MBO include Clinical evidence of bowel obstruction, obstruction distal to the Ligament of Treitz, presence of primary intraabdominal or extra abdominal cancer with peritoneal involvement. Materials: Detailed below are two cases of Malignant Bowel obstruction managed with Conservative inpatient nonoperative management with discussion of the proposed pharmacological protocol for the same. Case Details: A 45 year old Postmenopausal female diagnosed as carcinoma ovary stage iiic with left lower limb Deep Venous Thrombosis post multiple lines of chemotherapy including Paclitaxel plus Carboplatin, Etoposide, Tamoxifen and Liposomal Doxorubin, Malignant pleural effusion post thoracentesis was seen in the wards. A 31 year old Female a known case of moderately differentiated carcinoma colon with transmural infiltration and serosal seeding along with omental deposits with hepatic metastasis was seen in the casualty with signs of Multiple episodes of bilious vomiting with colicky abdominal pain and diagnosed to have malignant bowel obstruction on clinic radiological evaluation. Both these patients were provided non operative management of malignant bowel obstruction, were kept nil per oral, nasogastric decompression was performed with ryles tube insertion, antisecretory medication Inj Octreotide 100 ug three times daily, Anti Edema measures Inj Dexamethasone 8 mg intravrenous three times daily, Anti spasmodic and anti secretory medication Inj Hyoscine Butyl bromide 10 mg three times daily, inj Metronidazole 500 mg intravenous three times daily and Pain medication Inj Tramadol hydrochloride 50 mg intravenous in 100 ml of normal saline three times daily. Both these patients developed hyperglycemia which was managed with human regular insulin prescribed as per the sliding scale. Results: Ryles tube aspirate showed a decreasing trend and both the Patients achieved clinical resolution of symptoms underwent deintubation on Day 10 and Day 13 respectively and were taking oral feeds at the time of discharge. They were prescribed pharmacologic management of adhesive bowel obstruction consisting of Tab activated Dimethicone 40 mg three times daily, Tab Lactobacillus one tablet three times daily and Polyethylene glycol one satchet upto three times daily for 15 days at the time of discharge. Results: Resolution of symptoms can be achieved by providing non operative pharmacological management outlined above which consists of adequate hydration, parenteral nutrition when indicated, antibiotics, decongestive anti edema measures, anti spasmodic and anti secretory medication. Conclusion: Management of Hyperglycemia induced by Octreotide and Dexamethasone requires Insulin therapy. Optimum Duration, dosage and route of administration of Octreotide in management of Malignant Bowel Obstruction needs to be evaluated further.