Reserve Drug Indent Form and Its Impact on Antimicrobial Consumption and Sensitivity Pattern in the Medical Intensive Care Unit of a Tertiary Care Hospital

Shridhar, Deepthi P; Anitha, K B; Rai, Mohandas; Fernandes, Anisha

doi:10.7860/jcdr/2015/10974.5593

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…It is very important to protect the effectiveness of the current ACTs and WHO recommends monitoring the effectiveness of these ACTs through therapeutic efficacy studies [14] [34]. It is also important to have reserve drugs as options when there is reported drug resistance to the medicines in use [35]. For example, in Nigeria, artemether/lumefantrine is the medicine of choice with artesunate/amodiaquine as an alternative, and in Tanzania, artemether/lumefantrine is the first-line treatment for uncomplicated malaria in both adults and children, with dihydroartemisinin/piperaquine as a second-line treatment in cases of treatment failure [36] [37].…”

Section: Discussionmentioning

confidence: 99%

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Chimombe¹,

Mudenda²,

Bwalya³

et al. 2023

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Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all levels of society, with children under the age of five and pregnant women being most at risk of serious illness. The availability of antimalarial medicines is one of the key interventions of malaria management. This study assessed the availability of antimalarial medicines in community pharmacies in Lusaka district, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 210 community pharmacies from September to November 2022 using a well-structured checklist in selected areas of Lusaka district. The availability was verified by a physical check of the product. The checklist contained the medicines listed both in the guidelines for diagnosis and treatment of malaria in Zambia as well as in the World Health Organization (WHO) malaria treatment guidelines. Results: This study found that all antimalarials listed in the local treatment guidelines for malaria were available in community pharmacies, though with the varying distribution. Of the 210 community pharmacies, 209 (99.5%) had artemether/lumefantrine in stock. The lowest available antimalarial was quinine/clindamycin, which was only available in 3 (1.4%) of the outlets. Conversely, 3 out of 16 (18.8%) antimalarials that were available in community pharmacies were not listed in the local treatment guidelines of malaria in Zambia, despite being listed in the WHO malaria treatment guidelines. This translated into a compliance level of 81.2% based on the local malaria treatment guidelines. Conclusion: This study concluded that antimalarials were How to cite this paper: Chimombe, T.,

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Section: Discussionmentioning

confidence: 99%

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Chimombe¹,

Mudenda²,

Bwalya³

et al. 2023

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“…Four studies [52][53][54][55] assessed the impact of greater control of antibiotic prescriptions by a pharmacist at the hospital (Table 3). Two of these studies investigated a specific type of misuse, not mentioned previously: the absence or delay in switching from intravenous to oral administration [52,53].…”

Section: Control By the Pharmacistmentioning

confidence: 99%

“…Despite limitations inherent to its definition [65], it allows for comparisons between facilities and between countries [66]. This is why its use, in 10 studies, was valued by the relevance index [32][33][34][35]38,39,41,53,54,56].…”

Section: Evaluated Situations Of Misusementioning

confidence: 99%

Antibiotic misuse: How to evaluate the costs?

Silva

Cargnello

Aulois-Griot

et al. 2019

Médecine et Maladies Infectieuses

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Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review

Nathwani

Varghese

Stephens

et al. 2019

Antimicrob Resist Infect Control

315

209

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BackgroundHospital antimicrobial stewardship programs (ASPs) aim to promote judicious use of antimicrobials to combat antimicrobial resistance. For ASPs to be developed, adopted, and implemented, an economic value assessment is essential. Few studies demonstrate the cost-effectiveness of ASPs. This systematic review aimed to evaluate the economic and clinical impact of ASPs.MethodsAn update to the Dik et al. systematic review (2000–2014) was conducted on EMBASE and Medline using PRISMA guidelines. The updated search was limited to primary research studies in English (30 September 2014–31 December 2017) that evaluated patient and/or economic outcomes after implementation of hospital ASPs including length of stay (LOS), antimicrobial use, and total (including operational and implementation) costs.ResultsOne hundred forty-six studies meeting inclusion criteria were included. The majority of these studies were conducted within the last 5 years in North America (49%), Europe (25%), and Asia (14%), with few studies conducted in Africa (3%), South America (3%), and Australia (3%). Most studies were conducted in hospitals with 500–1000 beds and evaluated LOS and change in antibiotic expenditure, the majority of which showed a decrease in LOS (85%) and antibiotic expenditure (92%). The mean cost-savings varied by hospital size and region after implementation of ASPs. Average cost savings in US studies were $732 per patient (range: $2.50 to $2640), with similar trends exhibited in European studies. The key driver of cost savings was from reduction in LOS. Savings were higher among hospitals with comprehensive ASPs which included therapy review and antibiotic restrictions.ConclusionsOur data indicates that hospital ASPs have significant value with beneficial clinical and economic impacts. More robust published data is required in terms of implementation, LOS, and overall costs so that decision-makers can make a stronger case for investing in ASPs, considering competing priorities. Such data on ASPs in lower- and middle-income countries is limited and requires urgent attention.

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Reserve Drug Indent Form and Its Impact on Antimicrobial Consumption and Sensitivity Pattern in the Medical Intensive Care Unit of a Tertiary Care Hospital

Cited by 3 publications

References 16 publications

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines

Antibiotic misuse: How to evaluate the costs?

Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review

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