ABSTRACT
Background and Aim: In recent decades, the emergence of resistant strains of staphylococcus aureus, pneumococci, enterococcus and intestinal gram-negative bacteria due to the inappropriate use of antibiotics has emphasized the necessity of proper use of antibiotics. The aim of this study was to evaluate the appropriate antibiotic administration by general practitioner in the emergency department of a teaching hospital [Tohid Hospital] in Sanandaj, Iran
Material and methods: In this prospective descriptive study we evaluated the prescriptions for 170 patients who had been referring to the emergency department of Tohid Hospital in Sanandaj from May 2013 to May 2014. We selected 14 to 15 patients every month in a period of one year. After examination and writing prescriptions by the general practitioner, the patients were re-examined by an infectious diseases specialist. Finally, general practitioners and infectious diseases specialist's prescriptions data were recorded and compared with each other in regard to age, gender and prescribed drugs. Using spss v.18software the data were analyzed by descriptive statistics
Results: Among 170 patients, 52.4 percent[89] were male and 47.6 percent[81] were female with an average age of 39.86 +/- 15.44 years. According to the results of this study, 11.18 percent of patients who had received antibiotics prescribed by the general practitioner did not require antibiotics. The exact compatibility and similarity of the prescribed antibiotics by the general practitioner and infectious diseases specialist for a specific patient was 7.8 percent. The mean numbers of the drugs prescribed by general practitioner and infectious diseases specialist was 2.08 and 2.21, respectively. The most common prescribed antibiotics by the infectious diseases specialist and general practitioner were ciprofloxacin [13.3 percent] and azithromycin [13.3 percent]. Ciprofloxacin [21.3 percent] and cefixime [12 percent] were the most common antibiotics prescribed by the general practitioner
Conclusion: The findings of this study showed necessity of educational programs for general practitioners about antibiotic prescription
ABSTRACT
Background and Aim: Considering the importance of sepsis and its complications in the mortality of the patients admitted to different parts of hospital and the importance of early diagnosis and timely and appropriate treatment in the patients' survival, we investigated the value of procalcitonin serum level for the differential diagnosis between infectious and non-infectious SIRS in the patients referring to Tohid Hospital in Sanandaj
Material andmethods: In this descriptive analytical [case-control] study, we measured procalcitonin level in SIRS positive patients who had been referring to Tohid Hospital in Sanandaj.After obtaing the results of the lab.tests the patients were divided into two groups of infectious SIRS [case group] and non-infectious [control group] based on the final diagnosis made by our infectious diseases specialist. Patients withhistory of antibiotic intake within the last 48 hours, mechanical trauma, heat stroke, recent surgery, cancer and severe burn were excluded from the study. Each group consisted of 30 patients. Using SPSS software, data were analyzed by independent T-test to compare the quantitative data between the two groups. We also used Pearson correlation test to investigate the relationship between procalcitonin serum level and variables related to vital signs and blood markers. P<0.05 was considered significant
Results: Mean procalcitonin serum level in the case group was significantly higher than that in the control group, and the patients with higher respiratory rate and higher WBC counts had significant increase in procalcitonin serum level. Results of this study showed that the sensitivity, specificity and accuracy of procalcitonin test at the threshold of 0.52 ng / ml were 70 percent, 94 percent and 81.7 percent, respectively, and positive and negative predictive values were 75.7 percent and 91.3 percent, respectively
Conclusion: According to the results, procalcitonin level had a significant sensitivity and specificity in the differential diagnosis between infectious and non-infectious SIRS and can be considered as a diagnostic test along with other clinical and paraclinical criteria in the early stages of these disorders. This can be helpful in making early diagnosis and timely administration of medications