Drug safety in Pakistan

Atif, Muhammad; Malik, Iram; Asif, Muhammad; Qamar-Uz-Zaman, Muhammad; Ahmad, Nafees; Scahill, Shane

doi:10.1016/b978-0-12-819837-7.00024-8

Cited by 20 publications

(26 citation statements)

References 152 publications

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“…However, the consequences of inappropriate and unnecessary SM cannot be understated, as SM may lead to polypharmacy, incorrect diagnosis, adverse effects, drug interactions, antibiotic resistance, and increased drug expenses [ 2 , 3 , 10 ]. Healthcare policymakers prefer to promote law and policies in favor of prescribed drug use, but the challenges associated with SM in the general population cannot be ignored [ 18 ]. Thus, improved public awareness and education about the safe and rational use of drugs are necessary to overcome the challenges of SM.…”

Section: Self-medication (Sm) During Covid-19mentioning

confidence: 99%

“…A holistic approach should be taken to improve the use of SM through public education, sound training of healthcare professionals, including community pharmacists, and strict pharmaceutical regulations on public advertising and drug use. Positive support from national health authorities will reduce the potential risk of SM and reduce the stockpiling of drugs during this pandemic [ 18 , 19 ]. The authorities should provide proper strategies for drug usage.…”

Section: Controlling Sm In the Covid-19 Eramentioning

confidence: 99%

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Self-medication during Covid-19 pandemic: challenges and opportunities

Malik

Tahir

Jabbar

et al. 2020

Drugs Ther Perspect

138

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Section: Self-medication (Sm) During Covid-19mentioning

confidence: 99%

Section: Controlling Sm In the Covid-19 Eramentioning

confidence: 99%

Self-medication during Covid-19 pandemic: challenges and opportunities

Malik

Tahir

Jabbar

et al. 2020

Drugs Ther Perspect

138

View full text Add to dashboard Cite

“…Despite being described under the Drug Regulatory Authority of Pakistan (DRAP) Act 2012, a majority of pharmacy services don't exist in the country and only a few core services [8], such as dispensing, storage, distribution and management of therapeutic goods are available at drug retail outlets. However, there is a mounting list of previously known threats to the optimal use of medicines (e.g., adverse drug reactions, medication errors, misuse of controlled substances and excessive) [9] and medicinerelated practices (e.g., inappropriate use of medicines, especially antibiotics, formulation issues, over-the-counter (OTC) availability of prescription medicines, unsafe storage and disposal of medicines, and poor availability of medicines) that demand advanced community pharmacy services in the patient's welfare [10][11][12][13][14][15]. Whilst, in the current situation, when healthcare system is buckled under the burden of public health crisis and the country is attempting to adhere to the recommended preventive measures against COVID-19, full-blown community pharmacy services are urgently needed.…”

Section: Main Textmentioning

confidence: 99%

COVID-19 and community pharmacy services in Pakistan: challenges, barriers and solution for progress

Atif

Malik

2020

J of Pharm Policy and Pract

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In the wake of atrocious rise in COVID-19 cases, developed countries are leveraging a range of community pharmacy services with the goal of improving access to essential medication and healthcare services. While in the developing nations, including Pakistan, pharmacists are unable to perform COVID-19 containment roles in community, since presence of pharmacists at community pharmacy settings and delivery of pharmacy services have historically been plagued by shortcomings at various levels. In this document, we identified these shortcomings which need to be resolved on many fronts. Broadly, a number of intertwined government related, public related, academic curricula and pharmacist related, and drug retailers' related factors refrain community pharmacists from performing and facilitating Pakistan's fragile public and healthcare system in the midst of COVID-19 pandemic. Government led multifaceted approaches are urgently needed to strengthen this unrecognized domain and thereby effectively combat COVID-19 by utilizing community pharmacy services, as evidenced in the developed world. [Note: Part of this article is published in Pakistan Observer Newspaper; dated 17 May 2020).

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“…In this regard, it is important to know the bacterial isolates and their resistance pattern against commonly used antibiotics in neonatal sepsis not only at a country level but also at all levels of healthcare [ 3 ]. Based on the fact that neonatal mortality rate is very high in Pakistan [ 20 ] and sepsis is one of the major causes of neonatal mortality [ 6 , 10 ], such evidence based data will help the clinicians to initiate an empiric therapy which can decrease the probability of adverse outcomes among the patients. Despite the gravity of matter, only a few studies were conducted in Pakistan among neonatal sepsis patients [ 11 , 21 , 22 ], however, antibiotic use pattern and final treatment outcomes have not been discussed in detail.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan

et al. 2021

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Background Sepsis is one of the major causes of neonatal mortality in Pakistan. This study aimed to investigate the treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending a tertiary care hospital in Pakistan. We also aimed to identify the factors affecting mortality in neonatal sepsis patients. Methods A descriptive, cross-sectional study was conducted in the pediatric wards of the Bahawal Victoria Hospital, Bahawalpur, Pakistan. All eligible neonatal sepsis patients who were registered at the study site from January 1, 2019 to June 30, 2019 were included in the study. The data collection form included information on patient’s characteristics, antibiotic use and its sensitivity pattern, laboratory and microbiological data, and final treatment outcomes. Treatment outcomes included, discharged (with treatment success), leave against medical advice (LAMA), discharged on request (DOR) and death. Multivariable binary logistic regression analysis was used to find the independent factors associated with death. A p-value of less than 0.05 was considered statistically significant. Results Among the total 586 patients, 398 (67.9%) were male, 328 (56%) were preterm, 415 (70.8%) were diagnosed with early onset sepsis, 299 (51%) were born with low birth weight. Most of the patients (n = 484, 82.6%) were treated with amikacin+cefotaxime at the start of treatment. Culture was positive in 52 (8.9%) patients and the most commonly identified bacteria included, Klebsiella species (n = 19, 36.5%) followed by E. coli (n = 15, 28.5%) and Staphylococcus aureus (n = 8, 15.4%). The identified bacterial isolates showed high level of resistance against the antibiotics initiated at the start of the treatment, while resistance against piperacillin+tazobactam, imipenem, vancomycin and linezolid was very low. Just under half of the patients (n = 280, 47.8%) successfully completed the treatment (i.e., discharged with treatment success), while 123 (21%) patients died during treatment. In multivariable binary logistic regression, the factors which still remained significantly associated with neonatal death included, preterm delivery (AOR 9.59; 95% CI 4.41, 20.84), sub-optimal birth weight (AOR 5.13; 95% CI 2.19, 12.04), early onset sepsis (AOR 2.99; 95% CI 1.39, 6.41) and length of hospital stay (AOR 0.76; 95% CI 0.67, 0.88). Conclusion The mortality rate associated with sepsis was high in our study cohort. The bacterial isolates showed high level of resistance against the antibiotics started as the empiric therapy. Rational use of antibiotics can decrease the adverse outcomes in neonatal sepsis patients.

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Drug safety in Pakistan

Cited by 20 publications

References 152 publications

Self-medication during Covid-19 pandemic: challenges and opportunities

Self-medication during Covid-19 pandemic: challenges and opportunities

COVID-19 and community pharmacy services in Pakistan: challenges, barriers and solution for progress

Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan

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