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Malaria is an epidemic with 1.3% reduction in annual per capital economic growth rate. This study was to assess physicians’ antimalarial utilization in children below five years and conformity to guidelines. This is a retrospective and cross-sectional random sampling of prescriptions of antimalarials in under five between January 2012 and December 2014 in the secondary facility and January 2012 to December 2017 in two health facilities. Data was recorded using WHO indicator forms and analyzed using SPSS. Exactly, 800 prescriptions giving a total of 1,243 and 1313 drugs were prescribed in the Secondary Facility (CH), Warri and Primary Health Care (PHC), Oria respectively with an average of drugs prescribed per encounter (DPPE), CH (3.1 ± 0.01) and PHC, (3.3 ± 0.1). Antimalarials, were the most prescribed. Generic prescription was more in PHC (59%) than in CH (58%). Syrups were most prescribed 70.96% in CH, Warri and 53% in PHC, Oria. However, 27(50.9%) of physicians based prescription on experience, 13(24.5%) and 4(7.5%) followed WHO and National Antimalarial Treatment Policy (NATP) guidelines respectively while (17.1%) on the efficacy of the antimalarial. The antimalarial utilization practices conform to the WHO guidelines although there are lapses. Prescription was predominantly based on experience.
Malaria is an epidemic with 1.3% reduction in annual per capital economic growth rate. This study was to assess physicians’ antimalarial utilization in children below five years and conformity to guidelines. This is a retrospective and cross-sectional random sampling of prescriptions of antimalarials in under five between January 2012 and December 2014 in the secondary facility and January 2012 to December 2017 in two health facilities. Data was recorded using WHO indicator forms and analyzed using SPSS. Exactly, 800 prescriptions giving a total of 1,243 and 1313 drugs were prescribed in the Secondary Facility (CH), Warri and Primary Health Care (PHC), Oria respectively with an average of drugs prescribed per encounter (DPPE), CH (3.1 ± 0.01) and PHC, (3.3 ± 0.1). Antimalarials, were the most prescribed. Generic prescription was more in PHC (59%) than in CH (58%). Syrups were most prescribed 70.96% in CH, Warri and 53% in PHC, Oria. However, 27(50.9%) of physicians based prescription on experience, 13(24.5%) and 4(7.5%) followed WHO and National Antimalarial Treatment Policy (NATP) guidelines respectively while (17.1%) on the efficacy of the antimalarial. The antimalarial utilization practices conform to the WHO guidelines although there are lapses. Prescription was predominantly based on experience.
The development of monoclonal antibodies (mAbs) in recent decades has enhanced the therapeutic options available to clinicians for the treatment of several diseases such as cancer, autoimmune disorders, and several others. Monoclonal antibodies are produced through the use of different biotechnological techniques and rely on living systems as platforms for their production. Accordingly, mAbs are large proteins with complex three-dimensional structures and each production platform is unique for each mAb and producing exact copies of each mAb is nearly impossible. With several mAbs losing their patency in the previous two decades, many pharmaceutical companies are pursuing the production of generic mAbs, or what is known as biosimilars. The originator Bevacizumab has lost its patency in 2019 allowing several pharmaceutical companies to introduce into the clinic several Bevaciumab copies with varying degrees of quality with some being inferior to the originator Bevacizumab in what is known as intended copies. These agents and due to the lack of the totality of evidence for their comparability exercise needed versus the originator Bevacizumab could expose patients receiving these medications to several risks including lack of efficacy, immunogenicity, and potential toxicity. This review aims to provide pharmaceutical personnel working on the development and commercialization of Bevacizumab biosimilars in addition to regulatory officers worldwide responsible for the regulatory review of bevacizumab application dossiers with the minimal technical requirements required to perform a full comparability exercise between any bevacizumab biosimilar and its reference product. It will build on the EMA and U.S. FDA guidelines and the current literature to provide a comprehensive analysis of the various aspects of the bevacizumab comparability exercise and ensure that the product is of similar quality to the reference biologic.
Bali is one of the world's favorite travel destinations in developing countries. Most travelers who travel to developing countries seek medical assistance before, during and after travelling. Irrational prescribing is one of the causes of the higher medical cost. The objective was to evaluate drug prescriptions to foreign travelers in 2 travel clinics in Bali using the WHO prescribing indicators. This retrospective study used a cross-sectional method. Foreign travelers who took medication and received drug therapy at the travel clinics from January until December 2019 and had complete and legible medical record data were included in this study. Drug prescription were evaluated by following the WHO prescribing indicators, including the number of drugs per prescription sheet, the percentage of prescription drugs with generic names, the percentage of antibiotic prescriptions, the percentage of prescribed injections, and the percentage of drugs that were in accordance with the formulary. Drug use was said to berationalifall indicators were in accordance with WHO prescribing indicators where as it was said to be irrational if it did not meet the indicators set by WHO. We found a total number of prescriptions was 220 and the number of types of drugs in this study was 544. We found many poly pharmacy events, low prescriptions with generic names (14,2%), not all prescriptionsmetnationalformulary (64,8%), high prescriptions of antibiotic (50,0%) and injection (29,1%). Through this study, we concluded that there has been a phenomenon of irrational prescribing in those travel clinics.
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