ABSTRACT
Background: High rate of antibiotic prescription is commonly encountered in hospital settings. Although the problem of the irrational use of antibiotics is particularly acute in rural health centers of developing countries, antibiotic utilization studies in such areas are scarce. In this study, we aimed to compare antibiotic prescription patterns between inpatients and outpatients in a rural general hospital. Methods: Inpatient and outpatient records were evaluated during a 1-month period. Data including patients’ demographics, length of hospital stay, final diagnosis, antibiotic regimen, dosing, rout of administration, microbiological culture/sensitivity tests and other laboratory data were retrieved from the hospital information system. Results: The number of prescriptions with at least one antibiotic was 686/1410 (48.6%) cases and 3812/6126 (62.2%) cases for inpatient and outpatient prescriptions, respectively. The mean number of antibiotic per prescription was 1.7±0.7 and 1.3±0.8 for inpatient and outpatients, respectively (p<0.05). Ceftriaxone had the highest rate of prescription among hospitalized patients with 791 (35.2%) times encounter while penicillin constituted the largest proportion of outpatient administrations with 2505 (29.8%) times. About 79% of inpatient and 62% of outpatient prescriptions containing final diagnosis data had the correct indication. Conclusion: Our study showed that implementation of strict regulations for antibiotic use is extremely needed in this rural hospital. Establishing local guidelines, providing adequate education for healthcare professionals and putting restrictions for broadspectrum antibiotic use can be beneficial.
ABSTRACT
Introduction: Depression is one of the most common psychiatric disorders in old age. The aim of the study was to investigate the relationship between social support and depression in elderly population of Amirkola city, northern Iran. Also, a few studies have been conducted to determine whether there is any association between social support and depression in different cultural settings, e.g. in western countries. Methodology: This cross sectional study came from the Amirkola Health and Ageing Project (AHAP), that was undertaken among 1612 older people aged 60 years and over (881 males and 731 females) in Amirkola. The sampling method was done using the census records. Depression was assessed via the shortened 15 item version of Geriatric Depression Scale (GDS) and social support measured by the shortened 11 item version of the Duke Social Support Index (DSSI). Results: The prevalence of depressive symptoms was 43.4%. The mean social support score in the subjects without depressive symptoms was 28.32±2.79 which has been significantly higher than those with depressive symptoms 25.86±3.44. Linear regression analysis displays the variables in the final model like social support, age, gender, education, living status; social support was negatively the most associated variable with depression (β for social satisfaction= -0.245, P<0.001 and for social interaction 0 -0.199 P<0.001). Thus for the males, those who are younger, those who are more educated, those who are married and those who are employed, their social support scores were higher. Conclusions: Lack of social support is negatively associated with depression in the elderly people in Iran.