ABSTRACT
Overuse of injections is a common problem in many low-income and middle income countries. While cultural factors and attitudes of both physicians and patients are important factors, physicians financial intensives may play an important role in overprescribing of injections. This study was designed to assess the effects of providing injection services in physicians ambulatory offices on prescribing injectable medicines. This cross-sectional study was conducted in Tehran in 2012 -2013 and included a random sample of general physicians, pediatricians and infectious disease specialists. We collected data on the provision of injection services in or in proximity of physician offices, and obtained data from physicians prescriptions in the previous three-month period. We analyzed the data using ANOVA, Student>s t-test and linear regression methods. We obtained complete data from 465 of 600 sampled physicians. Overall 41.9% of prescriptions contained injectable medicines. 75% of physicians offered injection services in their offices. Male physicians and general physicians were more likely to offer the services, and more likely to prescribe injectables. We observed a clear linear relationship between the injection service working hours and the proportion of prescriptions containing injectables [p-value<0.001]. Providing injection service in the office was directly linked with the proportion of prescriptions containing injectables. While provision of injection services may provide a direct financial benefit to physicians, it is unlikely to be able to substantially reduce injectable medicines prescription without addressing the issue
ABSTRACT
Increasing antimicrobial resistance is now a critical point of human being in the world. Especially wide spectrum antibiotics resistance germs like vancomycin-resistant enterococci [VRE] should be dealt as soon as possible as an emergency conflict. Our study tries to reveal the amount of irrational use of vancomycin in a teaching hospital in Iran. We elected the whole inpatients that received vancomycin between February 2007 and May 2008. Forty four out of those 45 patients had inappropriate indication and dosing regimen of vancomycin [97.7%]. The most use of vancomycin was recorded in hematology - oncology ward and then Intensive Care Unit [ICU]. Culture responses were negative despite great clinical evidence of infection. Vancomycin irrational use was high compared to other countries and it could be concerned as a major health problem by health policy makers and physicians to deal. However more detailed researches are needed to reveal the other aspects of this problem. Implementation of antibiotic protocols and standard treatment guidelines are recommended