Provision of medication information may improve adherence and prevent medication related problems. People with mental health disorders commonly receive less medication counselling from pharmacists than people with other common long term and persistent disorders.ObjectiveThe objective of this study was to compare and contrast barriers pharmacy students perceive toward providing medication counselling for people with mental health disorders in Australia, Belgium, Estonia, Finland, India and Latvia.MethodsBarriers identified by third-year pharmacy students as part of the International Pharmacy Students’ Health Survey were content analysed using a directed approach. Students’ responses were categorised as pharmacist related, patient related, health-system related, or social or cultural related. Quantitative data were analysed using SPSS version 14.0.ResultsSurvey instruments were returned by 649 students. Of the respondents, 480 identified one or more barriers to medication counselling for people with mental health disorders. Patient related factors accounted for between 25.3% and 36.2% of barriers identified by the pharmacy students. Pharmacist related factors accounted for between 17.6% and 45.1% of the barriers identified by the pharmacy students. Students in India were more likely to attribute barriers to pharmacist and social and cultural related factors, and less likely to health-system related factors, than students studying in other countries.ConclusionThe nature of barriers identified by pharmacy students differed according to the country in which they studied. Undergraduate and postgraduate pharmacy education programs may need to be amended to address common misconceptions among pharmacy students.

Background Numbers of resistant pathogens are constantly increasing, and prudent use of antimicrobials is of paramount importance. In order to see whether any changes in the use of antimicrobials in recent years have occurred, we decided to monitor the consumption of these drugs at a single tertiary paediatric hospital. Materials and methods This single-centre retrospective study investigated the consumption of antimicrobials in defined daily doses (DDDs according to the Anatomical Therapeutical Chemical /DDD index) in a 130-bed paediatric tertiary hospital. The data on the consumption of antimicrobials were collected from years 2003-2013 by using electronic surveillance records provided by the local pharmacy. The consumption was related to days of hospital care. Results During 2003-2013, the use of penicillins, cephalosporins and carbapenems increased by 28%, 46% and 110%, respectively. The consumption of both aminoglycosides and vancomycin decreased by 61% and 41%, respectively. Amphotericin B use clearly decreased by 39% while the use of novel azoles and echinocandins increased. Conclusions Increased use of carbapenems was the most significant finding of our study. The year-to-year consumption of antibacterials was in general relatively stable and new antibacterials were taken into use conservatively. In contrast to antibacterials, novel antifungals were rapidly adopted into use despite scarce evidence on their safety in children. INTRODUCTIONInvestigating and monitoring the consumption of antimicrobials in hospitals is necessary in order to encourage prudent use of these drugs. The use of broad spectrum antibacterials is a potential problem. It causes selection pressure and may lead to increasing numbers of resistant pathogens. In addition, such use of antibacterials most probably also causes difficult secondary infections. Similarly, local knowledge on the use of antimicrobials is crucial and allows us to implement necessary measures to support appropriate use of antimicrobials.When investigating the consumption of antimicrobials, defined daily doses (DDDs) can be used. DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.3 4 Numerous studies have investigated the consumption of antimicrobials in hospitalised adult patients by using DDDs, 5-8 but such studies in paediatric patients are in large scale missing.There are obvious obstacles when using DDDs in children. The most important being that the paediatric population is a very heterogeneous group with great variation in weight and age. Thus, comparing neonatal use with that of the adolescents is very challenging. The DDDs may, however, be used to describe paediatric consumption of individual antimicrobials over a certain period of time in a setting where no major changes in the hospital clientele took place.We have studied the consumption of these drugs in the Children's Hospital, University of Helsinki, by using DDDs as parameters of antibiotic use. The overall age bands of our patients have stayed...

More studies in neonates on especially dosing and pharmacokinetics of antimicrobials are urgently needed.

AimKnowledge of the quality of antimicrobial therapy (AMT) used for invasive healthcare-associated infections (HAIs) in paediatrics is scarce. Influence of the final information about the isolated pathogen on the subsequent targeted AMT was investigated in our study.MethodsData on 149 children (0–17 years) with blood culture positive HAIs were collected. The causative microbes under investigation were Staphylococcus aureus, Staphylococcus epidermidis, streptococci, Gram negative rods, and mixed infections were likewise included. For adjusting the antimicrobial regimen, an expert panel evaluated the quality of the targeted AMT and the delay of 72 hours after final microbiology results. AMT was regarded as inappropriate if the pathogen was totally resistant to the used antimicrobials (i) or if the chosen therapy was of not optimal efficacy against the pathogen (ii).Results17% of the patients received inappropriate AMT. Half of these infections 13/26 (50%) were treated with an antimicrobial to which the isolate was resistant. Three (3/13, 23%) of these patients received antimicrobials which were totally ineffective according to in vitro data. Suboptimal or too broad spectrum AMT was administered to 13/26 (50%) patients. The most common causes of inappropriate use were the use of beta-lactams in oxacillin-resistant Staphylococcus epidermidis infections and vancomycin given in oxacillin-sensitive Staphylococcus aureus infections.ConclusionApproximately 17% of the selected cohort received inappropriate AMT. More attention should be paid to the appropriate use of antimicrobials, and training of prescribers should be urgently provided.