Impact of therapeutic guidelines on antibiotic use by residents in primary care clinics

Faryna, Alice; Wergowske, Gilbert L.; Goldenberg, Kim

doi:10.1007/bf02596306

Cited by 38 publications

(17 citation statements)

References 18 publications

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“…Educating practitioners in small groups led by an expert also results in a significant reduction of drug consumption (Madridejos-Mora et al, 2004; Ranji et al, 2008). Conversely, wide diffusion of treatment guidelines appears to produce less tangible results (Faryna et al, 1987; Al-Momany et al, 2009). …”

Section: Priority Actions To Minimize the Impact Of Veterinary Antimimentioning

confidence: 99%

Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production

2017

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The growing concern regarding emergence of bacteria resistant to antimicrobials and their potential for transmission to humans via animal production has led various authorities worldwide to implement measures to decrease antimicrobial use (AMU) in livestock production. These measures are influenced by those implemented in human medicine, and emphasize the importance of antimicrobial stewardship, surveillance, infection prevention and control and research. In food producing animals, unlike human medicine, antimicrobials are used to control diseases which cause economic losses. This major difference may explain the failure of the public policies implemented to control antimicrobial usage. Here we first review the specific factors influencing AMU across the farm animal sector and highlighting the farmers’ decision-making process of AMU. We then discuss the efficiency of existing regulations implemented by policy makers, and assess the need for alternative strategies, such as substitution between antimicrobials and other measures for infectious disease control. We also discuss the interests of regulating antimicrobial prices. Finally, we emphasize the value of optimizing antimicrobial regimens, and developing veterinary precision medicine to achieve clinical efficacy in animals while limiting negative impacts on public health. The fight against antimicrobial resistance requires both a reduction and an optimization of antimicrobial consumption. The set of actions currently implemented by policy makers does not adequately address the economic interests of farmers’ use of antimicrobials.

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Section: Priority Actions To Minimize the Impact Of Veterinary Antimimentioning

confidence: 99%

Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production

2017

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“…Antibiotics are currently the most commonly prescribed drugs in hospitals, worldwide. [2] But, excessive and inappropriate use of antibiotics renders increased drug resistance. [3] The rational use of antibiotics is a major health need.…”

Section: Introductionmentioning

confidence: 99%

Antibiotics prescribing pattern in the in-patient departments of a tertiary care hospital

Remesh¹,

Salim²,

Gayathri³

et al. 2013

Arch Pharma Pract

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Context: Antibiotic prescribing by physicians has gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections, and drug resistances. Aims: The present study aimed to evaluate the prescribing pattern of antibiotics, their adherence to essential medicines list, disease conditions for which they were prescribed, and their adverse effects. Settings and Design: A cross-sectional prospective study was carried out in six inpatients departments (Surgery, Orthopedics, ENT, Ophthalmology, Medicine, and Pediatrics) of a 550-bed tertiary care hospital in Trivandrum, India for two months (July-August 2012). Institutional Research and Ethics Committee clearance were obtained prior to the study. Materials and Methods: The data were collected in a predesigned performa from the medical case sheets, drug charts, and laboratory investigations of 100 in-patients. The enrolled patients were observed from admission till discharge. Descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Results: The mean duration of hospitalization among the study population was 5.48 (±4.28) days. Of the 410 medicines prescribed, antibiotics contributed 151 (36.8%). They were mostly indicated for respiratory infections, and the most common antibiotic was Beta-lactams (91 (60.2%). Interestingly, 89 antibiotics (60%) were administered as injections. About 70 (46%) of the antibiotics were prescribed without any combinations. The adherences to World Health Organization's essential medicines list were 122 (81%). A total of seven adverse drug reactions were reported in the current study. Of which, none were serious, and five (70%) were cutaneous reactions. Conclusions: Of the 100 patients analyzed from six in-patient departments, it was observed that the hospital physicians prescribed antibiotics more rationally with no banned drugs and less newer drugs. Rational prescribing of antibiotics would help avoid polypharmacy and prevent drug resistances.

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“…Antibiotics have effectively prolonged the life expectancy and are currently the most commonly prescribed drugs in hospitals worldwide [7]. However, studies indicated that antibiotics are among the major group of drugs which cause ADRs [8].…”

Section: Introductionmentioning

confidence: 99%

Patterns of Prescription and Antibiotic Use Among Outpatients in a Tertiary Care Teaching Hospital of Bangladesh

Datta

Paul

Monwar

et al. 2016

Int J Pharm Pharm Sci

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Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh.Methods: This prospective survey was conducted among the out-patients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to World Health Organisation (WHO).Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%). Conclusion:Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients.

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Impact of therapeutic guidelines on antibiotic use by residents in primary care clinics

Cited by 38 publications

References 18 publications

Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production

Addressing Antimicrobial Resistance: An Overview of Priority Actions to Prevent Suboptimal Antimicrobial Use in Food-Animal Production

Antibiotics prescribing pattern in the in-patient departments of a tertiary care hospital

Patterns of Prescription and Antibiotic Use Among Outpatients in a Tertiary Care Teaching Hospital of Bangladesh

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