Construção e validação de ferramenta preventiva sobre incompatibilidade medicamentosa em via Y / Construction and validation of a preventive tool on drug incompatibility in the Y-route / Construcción y validación de una herramienta preventiva de incompatibilidad de medicamentos en la ruta Y

Introdução: A terapia com medicamentos endovenosos é muito utilizada nas unidades hospitalares, porém, possui uma elevada chance de incidentes, principalmente quando os medicamentos são administrados simultaneamente em via Y. Essa prática pode resultar em incompatibilidades medicamentosas classificadas em reações físicas e químicas. Objetivo: Construir e validar uma ferramenta preventiva de incompatibilidade medicamentosa em via Y. Método: Estudo metodológico com abordagem quantitativa. Foi desenvolvido em três etapas: Levantamento bibliográfico, construção e diagramação do material e por fim, a validação da ferramenta preventiva. Para validação, a ferramenta preventiva foi submetida ao processo de validação de face e conteúdo por juízes com expertise na temática. Resultados: Construiu-se e validou-se uma ferramenta preventiva através da busca de dados na literatura com a participação de sete juízes especialistas na temática. Os itens avaliativos referentes a tabela de incompatibilidade medicamentosa quanto aos objetivos, estrutura, apresentação e relevância da ferramenta preventiva foi considerada válida, pois foram julgados como adequado pelos especialistas. Conclusão: A validação de conteúdo, foi considerada válida pelos juízes, portanto, espera-se que o material alcance o seu objetivo ao ser aplicado durante a prática clínica. Dessa forma, será disponibilizado à instituição para que seja utilizado, favorecendo a prevenção de danos e contribuindo para a segurança dos pacientes, bem como melhorando a qualidade da assistência e educação em saúde.

Introduction: Intravenous drug therapy is widely used in hospital units, however, it has a high chance of incidents, especially when drugs are administered simultaneously in a Y route. This practice can result in drug incompatibilities classified into physical and chemical reactions. Objective: To build and validate a preventive tool for drug incompatibility in the Y pathway. Method: Methodological study with a quantitative approach. It was developed in three stages: bibliographic survey, construction and layout of the material and finally, the validation of the preventive tool. For validation, the preventive tool was submitted to the face and content validation process by judges with expertise in the subject. Results: A preventive tool was built and validated through the search for data in the literature with the participation of seven expert judges on the subject. The evaluative items referring to the medication incompatibility table regarding the objectives, structure, presentation and relevance of the preventive tool were considered valid, as they were judged as adequate by the specialists. Conclusion: The content validation was considered valid by the judges, therefore, it is expected that the material reaches its objective when applied during clinical practice. In this way, it will be made available to the institution for use, favoring the prevention of damage and contributing to patient safety, as well as improving the quality of health care and education.

Introducción: La farmacoterapia intravenosa es ampliamente utilizada en las unidades hospitalarias, sin embargo, tiene una alta probabilidad de incidencias, especialmente cuando los fármacos se administran simultáneamente en una vía Y. Esta práctica puede dar lugar a incompatibilidades medicamentosas clasificadas en reacciones físicas y químicas. Objetivo: Construir y validar una herramienta preventiva de incompatibilidad de medicamentos en la vía Y. Método: Estudio metodológico con enfoque cuantitativo. Se desarrolló en tres etapas: relevamiento bibliográfico, construcción y diagramación del material y finalmente, la validación de la herramienta preventiva. Para la validación, la herramienta preventiva fue sometida al proceso de validación facial y de contenido por jueces expertos en el tema. Resultados: Se construyó y validó una herramienta preventiva a través de la búsqueda de datos en la literatura con la participación de siete jueces expertos en el tema. Los ítems evaluativos referentes a la tabla de incompatibilidad de medicamentos en relación a los objetivos, estructura, presentación y relevancia de la herramienta preventiva fueron considerados válidos, pues fueron juzgados como adecuados por los especialistas. Conclusiones: La validación del contenido fue considerada válida por los jueces, por lo tanto, se espera que el material alcance su objetivo al ser aplicado durante la práctica clínica. De esta forma, se pondrá a disposición de la institución para su uso, favoreciendo la prevención de daños y contribuyendo a la seguridad del paciente, además de mejorar la calidad de la atención y educación en salud.

Cinamaldeído e terpineol como inibidores de biofilmes de Candida albicans e Enterococcus faecalis / Cinamaldehído y terpineol como inhibidores de biopelículas de Candida albicans y Enterococcus faecalis / Cinnamaldehyde and terpineol as inhibitors of Candida albicans and Enterococcus faecalis biofilms

Introdução: Os fitoconstituintes são moléculas naturais que apresentam atividade antimicrobiana satisfatória e devem ser estudados quanto ao seu uso como novas substâncias para irrigação dos canais radiculares. Objetivo: Avaliar o efeito inibitório dos fitoconstituintes cinamaldeído e α-terpineol frente a biofilmes monoespécie e duoespécie de microrganismos envolvidos na infecção endodôntica. Métodos: Trata-se de um estudo experimental na área de microbiologia aplicada, in vitro, cego quanto às análises e randomizado. Foram selecionados os fitoconstituintes cinamaldeído e α-terpineol. A atividade antimicrobiana frente Candida albicans e Enterococcus faecalis foi avaliada por meio da análise da capacidade metabólica com o uso da resazurina e análise da viabilidade celular pelo plaqueamento. O meio de cultura e a clorexidina 1 porcento serviram de controle negativo e positivo, respectivamente. Resultados: Observou-se ausência de crescimento para exposição dos biofilmes nas concentrações de 10 e 5 mg/mL de ambos os fitoconstituintes. Na concentração de 2,5 mg/mL de terpineol, constatou-se crescimento somente nos biofilmes monoespécie de C. albicans e duoespécie. Já na concentração de 1mg/mL de terpineol e cinamaldeído, verificou-se crescimento para todos os biofilmes. Conclusão: O cinamaldeído e α-terpineol apresentaram atividade inibitória frente biofilmes monoespécie e duoespécie de Candida albicans e Enterococcus faecalis, nas concentrações de 10 e 5 mg/mL(AU)

Introducción: Los fitoconstituyentes son moléculas naturales que presentan actividad antimicrobiana satisfactoria y deben ser estudiados en cuanto a su uso como nuevas sustancias para irrigación de los canales radiculares. Objetivo: Evaluar el efecto inhibitorio de fitoconstituyentes cinamaldehído y α-terpineol frente a biopelículas monoespecies y duoespecies de microorganismos involucrados en la infección endodóntica. Métodos: Estudio experimental en el campo de la microbiología aplicada, in vitro, ciego al análisis y aleatorizado. Se seleccionaron los fitoconstituyentes cinamaldehído y α-terpineol. La actividad antimicrobiana frente Candida albicans y Enterococcus faecalis fue evaluada por medio del análisis de la capacidad metabólica con el uso de la resazurina y análisis de la viabilidad celular por el plaqueamiento. El medio de cultivo y la clorexidina 1 por ciento sirvieron de control negativo y positivo, respectivamente. Resultados: Se observó ausencia de crecimiento para exposición de las biopelículas en las concentraciones de 10 y 5 mg/mL de ambos fitoconstituyentes. En la concentración de 2,5 mg/mL de terpineol se constató crecimiento solo en los biofilmios monoespecies de C. albicans y duoespecies. En la concentración de 1 mg/mL de terpineol y cinamaldehído se verificó crecimiento para todas las biopelículas. Conclusiones: Cinamaldehído y α-terpineol presentaron actividad inhibitoria frente a biofilmes monoespecies y duoespecies de Candida albicans y Enterococcus faecalis, en las concentraciones de 10 y 5 mg/mL(AU)

Introduction: Phytoconstituents are natural molecules displaying satisfactory antimicrobial activity. Studies should be conducted about their use as new root canal irrigants. Objective: Evaluate the inhibitory effect of the phytoconstituents cinnamaldehyde and α-terpineol against mono- and duo-species biofilms of microorganisms involved in endodontic infection. Methods: An experimental applied microbiology blind randomized in vitro study was conducted. The phytoconstituents selected were cinnamaldehyde and α-terpineol. Antimicrobial activity against Candida albicans and Enterococcus faecalis was evaluated by metabolic capacity analysis with resazurin and cell viability analysis by the plaque. The culture medium and 1 percent chlorhexidine served as negative and positive controls, respectively. Results: An absence of growth was observed for exposure of the biofilms at concentrations of 10 and 5 mg/ml of both phytoconstituents. At a concentration of 2.5 mg/ml terpineol displayed growth only in the mono-species biofilms of C. albicans and duo-species biofilms. At a concentration of 1 mg/ml terpineol and cinnamaldehyde displayed growth in all biofilms. Conclusions: Cinnamaldehyde and α-terpineol displayed inhibitory activity against mono- and duo-species biofilms of Candida albicans and Enterococcus faecalis at concentrations of 10 and 5 mg/ml(AU)

O uso da lock terapia na prevenção e tratamento de infecção relacionada ao cateter venoso central de longa permanência: revisão integrativa / Using lock therapy to prevent and treat long-term central venous catheter-related infections: an integrative review

Introdução: A lock terapia, ou terapia de bloqueio, consiste na administração e manutenção de uma solução, em concentração supra terapêutica, nos cateteres venosos centrais. Estas soluções combinam antimicrobianos altamente concentrados com um anticoagulante, sendo aplicáveis tanto para a prevenção, quanto para o tratamento da infecção relacionada ao cateter. Objetivo: Sintetizar o conhecimento sobre o uso da lock terapia na prevenção e tratamento de infecção relacionada ao cateter intravascular de inserção central. Método: Revisão integrativa da literatura, sendo a busca realizada nas seguintes bases de dados CINAHL, Cochrane Central, Embase, LILACS, PubMed, Scopus e Web of Science, abrangendo o período de 1 janeiro de 2010 a 3 de março de 2020, sem restrições de idioma. As referências foram exportadas para o gerenciador EndNote e para o Rayyan, para a seleção dos estudos. As etapas de amostragem, categorização dos estudos, avaliação dos estudos incluídos, interpretação dos resultados e síntese do conhecimento foram realizadas por dois revisores de forma independente. Em seguida, foi realizada uma busca manual nas referências dos estudos incluídos. Os dados foram analisados de forma descritiva. Resultados: A amostra compilou 15 estudos. Seis estudos (40%) abordaram o uso da lock terapia como prevenção de infecção relacionada ao cateter venoso central, e nove artigos (60%) abordaram tal terapia como tratamento. Os artigos incluídos nessa revisão que abordaram a prevenção relatam o uso de soluções antimicrobianas não antibióticas (taurolidina (n=2), etanol (n=2), citrato trissódico (n=1) e nitroglicerina (n=1)). Dentre os nove estudos que abordaram a lock terapia como tratamento para a infecção, a maioria (n=7) utilizou soluções antibióticas, (dois estudos avaliaram a eficácia da daptomicina e os outros cinco utilizaram soluções antibióticas variadas). Os outros dois estudos utilizaram soluções antimicrobianas (ácido clorídrico e taurolidina) associadas com antibioticoterapia sistêmica. Dentre os 15 estudos, em apenas um não foi possível especificar a duração da intervenção. Dois avaliaram a eficácia da lock terapia em curta duração (de três a quatro dias) e seis avaliaram em maior duração (entre 10 e 14 dias). Cada estudo especificou uma técnica de intervenção e o tempo de permanência da solução intraluminal. Em relação ao risco de viés, foram avaliados cinco ensaios clínicos randomizados pela ferramenta da Cochrane Risk of Bias (RoB 2), sendo todos de baixo risco. Dois ensaios clínicos sem randomização avaliados pela ferramenta proposta pelo Joanna Briggs Institute (JBI) resultaram em risco de viés baixo. Dentre os oito estudos observacionais, a ferramenta AXIS avaliou sete como sendo de baixo risco e um como risco moderado. Conclusões: Na prevenção identificou-se o uso de antimicrobianos não antibióticos como o etanol. A taurolidina também foi utilizada em um estudo relacionado ao tratamento, em associação com antibioticoterapia sistêmica. Em três estudos sintetizados para as situações de tratamento da infecção relacionada ao cateter, o antibiótico utilizado foi a daptomicina endovenosa. Tais antibióticos sistêmicos, utilizados concomitantemente na maioria dos estudos de tratamento, foram selecionados em conformidade com o resultado da hemocultura e antibiograma

Introduction: Lock therapy, or blockade therapy, is the administration and maintenance of a solution, at a dosage higher than the therapeutic one, in central venous catheters. Blockade solutions combine highly concentrated antimicrobials with an anticoagulant. They can be applied to both prevent and treat catheter-related infections. Objective: To summarize the knowledge about use of lock therapy to prevent and treat intravascular catheter-related infections. Methods: Integrative literature review, whose search was carried out in the databases CINAHL, Cochrane Central, Embase, LILACS, PubMed, Scopus and Web of Science, considering the period from January 1, 2010 to March 3, 2020, without any languages restriction. The references were exported to EndNote and subsequently to Rayyan, so studies could be selected. Sampling, study categorization, study evaluation, interpretation of results, and synthesis of knowledge were executed by two researchers independently and blindly. A manual search was then carried out in the references of the included articles. The data were analyzed descriptively. Results: The final sample was composed of 15 studies. Six studies (40%) addressed the use of lock therapy to prevent central venous catheter-related infections and nine publications (60%) addressed this therapy as a form of treatment. The articles included in this review that addressed prevention reported use of nonantibiotic antimicrobial solutions (taurolidine (n=2), ethanol (n=2), trisodium citrate (n=1), and nitroglycerin (n=1)). Among the nine studies that evaluated lock therapy as a treatment alternative, most (n=7) described the use of antibiotic solutions (two evaluated the effects of daptomycin and five reported the application of varied antibiotic solutions). The other two articles described use of antimicrobial solutions (hydrochloric acid and taurolidine) associated with systemic antibiotic therapy. Among all 15 studies, one did not specify the intervention duration, two assessed the efficacy of lock therapy in the short term (from three to four days), and six assessed it within a longer duration (between 10 and 14 days). Each study specified an intervention technique and length of permanence of the intraluminal solution. Regarding risk of bias, five randomized clinical trials were evaluated with the tool Cochrane Risk of Bias (RoB 2), which indicated all as low risk of bias. Two nonrandomized clinical trials were assessed through the tool proposed by the Joanna Briggs Institute, and resulted in low risk of bias. Among all eight observational studies, the AXIS tool evaluated seven as showing low risk of bias and one as moderate risk of bias. Conclusions: Regarding prevention, the studies reported the use of non-antibiotic antimicrobials such as ethanol. The taurolidine was also mentioned in a study describing therapeutic applications, in combination with systemic antibiotic therapy. In three studies addressing treatment of catheterrelated infections, the antibiotic used were Daptomycin. These systemic antibiotics, which were concomitantly used in most treatment studies, were chosen according to the results of blood culture with antibiogram

Biological activities: anti-infectious, antioxidant and healing of the vegetable species Jatropha multifida / Actividades biológicas: antiinfecciosas, antioxidantes y cicatrizantes de la especie vegetal Jatropha multifida / Atividades biológicas: anti-infecciosa, antioxidante e cicatrizante da espécie vegetal Jatropha multifida

ABSTRACT Objective: to investigate the biological activities of interest to the health of Jatropha multifida plant species in published scientific literature. Methods: this is an integrative review, with searches between May and June 2019, using the descriptors, combined through the Boolean operator AND, Jatropha multifida, anti-infective agents, wound healing, cytotoxicity and antioxidants, in LILACS, BDENF, MEDLINE, SciFinder, Web of Science and Scopus databases and in the virtual libraries SciELO and ScienceDirect. Results: twelve publications were retrieved that showed nine biological activities. The antioxidant activity was reported in 04 (33.33%) studies; antimicrobial and anticancer, addressed by 03 (25%) and 02 (16.66%); anti-inflammatory, anti-melanin deposition, healing, antiophidic, purgative and anti-influenza, seen in 01 (8.33%) each. Final considerations: although scarce, the published scientific production highlights the biological potential of J. multifida and supports the need for further studies.

RESUMEN Objetivo: investigar las actividades biológicas de interés para la salud de la especie vegetal Jatropha multifida en la literatura científica publicada. Métodos: se trata de una revisión integradora, con búsquedas entre mayo y junio de 2019, utilizando los descriptores, combinados mediante el operador booleano AND, Jatropha multifida, anti-infective agentes, wound healing, cytotoxicity y antioxidants en las bases de datos LILACS, BDENF, MEDLINE, SciFinder, Web of Science y Scopus y en las bibliotecas virtuales SciELO y ScienceDirect. Resultados: se recuperaron 12 publicaciones que mostraron nueve actividades biológicas. La actividad antioxidante se informó en 04 (33,33%) estudios; antimicrobiano y anticancerígeno, abordado por 03 (25%) y 02 (16.66%); antiinflamatorio, anti-depósito de melanina, cicatrizante, anti-fálico, purgante y anti-influenza, visto en 01 (8,33%) cada uno. Consideraciones finales: aunque escasa, la producción científica publicada destaca el potencial biológico de J. multifida y apoya la necesidad de más estúdios.

RESUMO Objetivo: investigar as atividades biológicas de interesse à saúde da espécie vegetal Jatropha multifida na literatura científica publicada. Métodos: trata-se de uma revisão integrativa, com buscas entre maio e junho de 2019, utilizando-se os descritores, combinado por meio do operador booleano AND, Jatropha multifida, anti-infective agentes, wound healing, cytotoxicity e antioxidants, nas bases nas bases de dados LILACS, BDENF, MEDLINE, SciFinder, Web of Science e Scopus e nas bibliotecas virtuais SciELO e ScienceDirect. Resultados: foram resgatadas 12 publicações que evidenciaram nove atividades biológicas. A atividade antioxidante foi relatada em 04 (33,33%) pesquisas; antimicrobiana e anticancerígena, abordadas por 03 (25%) e 02 (16,66%); anti-inflamatória, anti-deposição de melanina, cicatrizante, antiofídica, purgativa e anti-influenza, vistas em 01 (8,33%) cada. Considerações finais: embora escassa, a produção científica publicada evidencia o potencial biológico de J. multifida e apoia a necessidade de mais estudos.

Recovery rates of combination antibiotic therapy using in vitro microdialysis simulating in vivo conditions / 药物分析学报

Microdialysis is a technique used to measure the unbound antibiotic concentration in the interstitial spaces, the target site of action. In vitro recovery studies are essential to calibrating the microdialysis system for in vivo studies. The effect of a combination of antibiotics on recovery into microdialysate requires investigation. In vitro microdialysis recovery studies were conducted on a combination of vancomycin and tobramycin, in a simulated in vivo model. Comparison was made between recoveries for three different concentrations and three different perfusate flow rates. The overall relative recovery for vancomycinwas lower than that of tobramycin. For tobramycin, a concentration of 20μg/mL and flow rate of 1.0μL/min had the best recovery. A concentration of 5.0μg/mL and flow rate of 1.0μL/min yielded maximal recovery for vancomycin. Large molecular size and higher protein binding resulted in lower relative recoveries for vancomycin. Perfusate flow rates and drug concentrations affected the relative recovery when a combination of vancomycin and tobramycin was tested. Low perfusate flow rates were associated with higher recovery rates. For combination antibiotic measurement which includes agents that are highly protein bound, in vitro studies performed prior to in vivo studies may ensure the reliable measurement of unbound concentrations.

MEDICIÓN DE LA ADHERENCIA AL LAVADO DE MANOS, SEGÚN LOS CINCO MOMENTOS DE LA OMS / MEASUREMENT OF HANDWASHING ADHERENCE, ACCORDING TO FIVE MOMENTS OF THE WHO

El contacto con objetos y personas en el entorno hospitalario favorece la propagación de gérmenes que amenazan a los pacientes; el lavado de manos es una estrategia clave para prevenir infecciones. En este estudio, transversal y cuantitativo, se midió la adherencia al lavado de manos en personal ambulatorio y de urgencias de Assbasalud ESE, según los cinco Momentos de la Higiene de las Manos de la OMS, y se evaluó el impacto después de impartir capacitación. Lo anterior se realizó en tres fases: precapacitación, capacitación y poscapacitación, las cuales contaron con el aval del Comité de Calidad de la IPS. En la formación se tuvieron en cuenta las etapas de la higiene de manos, el uso de esmaltes y joyas y la pertinencia de las sustancias empleadas para la asepsia. La adherencia obtenida al lavado de manos en la primera fase fue del 61,8% y en la segunda, del 78,3%. Estos resultados son positivos con relación a estudios internacionales. Se concluye que el lavado de manos, valorado en 78,3% durante el cuarto trimestre de 2013, es una excelente estrategia para prevenir infecciones hospitalarias.

Contact with objects and people in the hospital environment promotes the spread of germs that threaten patients; hand washing is a key strategy to prevent infections. Adherence to hand washing of health care officials was measured according to the Five Moments of Hand Hygiene of the WHO (World Health Organization). This transversal and quantitative study evaluated the adherence to hand washing in outpatient and emergency personnel of Assbasalud ESE, as well as the impact after receiving training. It was conducted in three phases: pre-training, training and post-training. The final sample was 128 employees in nine bank suite's (30%). The adhesion measurement was approved by the Executive Quality Committee of Assbasalud ESE. The factors that were evaluated were: hand hygiene, use of nail polish and use of jewels, as well as the relevance of the substances used for aseptic. The overall adherence of hand washing in phase one was of 61.8% and for the second phase, of 78.3%. These are positive results with reference to national and international studies. It was concluded that hand washing, valued at 67.1% during the third quarter of 2013, is an excellent strategy to reinforce patient safety and to prevent hospital infections.

Propuesta de guía farmacológica de medicamentos antiinfecciosos esenciales pertenecientes al grupo J01 registrados en la República Bolivariana de Venezuela / Proposed anti drug drug guide core group belonging to J01 registered in the Republic of Venezuela

En la actualidad, el personal de salud que se encarga de la prescripción y dispensación del tratamiento farmacológico a los pacientes y no cuenta con un documento de consulta oficial que abarque únicamente medicamentos de tipo antiinfecciosos cuya elaboración se realice con información aprobada por la Autoridad Reguladora Nacional, el Instituto Nacional de Higiene "Rafael Rangel", ente encargado de evaluar que los medicamentos comercializados en Venezuela cumplan con los requerimientos exigidos de calidad, seguridad y eficacia necesarios para el resguardo de la salud pública. Esta propuesta de Guía Nacional para Medicamentos Antiinfecciosos pertenecientes al Grupo J01, es una recopilación sintética de fichas técnicas-científicas individuales para este tipo de fármacos hasta el primer semestre del año 2014, que se realiza teniendo como base distintos criterios de justificación, tales como: la inclusión de medicamentos comercializados desde 2004, año de última actualización del Formulario Terapéutico Nacional; las altas tasas de morbilidad y mortalidad en Venezuela como consecuencia de enfermedades infecciosas; orientación integral confiable dirigida al personal de salud en cuanto a la prevención, tratamiento, uso racional y eficacia de los medicamentos antiinfecciosos, entre otros.

Currently, the health personnel in charge of prescribing and dispensing of drug treatment to patients and does not have a formal consultation document covering only type of anti-infective drugs whose development is done with information approved by the National Regulatory Authority the National Institute of Hygiene "Rafael Rangel" body responsible for assessing the drugs marketed in Venezuela meet the requirements demanded of quality, safety and efficacy necessary for safeguarding public health. This proposed National Anti-Infective Drugs Guide J01 belonging to the Group, is a synthetic compilation of technical-scientific individual records for such drugs through the first half of 2014, which is done on the basis of justification different criteria, such as: the inclusion of drugs marketed since 2004, last updated National Drug Formulary; high rates of morbidity and mortality in Venezuela as a result of infectious diseases; comprehensive guidance to reliable health personnel about the prevention, treatment, rational use and effectiveness of anti-infective drugs, among others.

Antimicrobial Resistance Evaluation of Organisms Isolated from Liquid Herbal Products Manufactured and Marketed in South Eastern Nigeria.

Objective: To determine the susceptibility and resistance pattern of bacteria and fungi isolates obtained from herbal anti-infective liquid preparations manufactured and marketed in South-East Nigeria to conventional antibiotics. Study Design: Experimental Place and Duration of the study: Pharmaceutical Microbiology and biotechnology Laboratory, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu Campus between October 2011 and March 2012. Methodology: Isolation and characterization of contaminating microorganisms were carried out using standard procedures. A total of forty-nine (49) bacteria and forty (40) fungi isolated from the herbal products were examined for susceptibility to conventional antibiotics using the disc diffusion method. The bacterial isolates were tested against ciprofloxacin, ofloxacin, amoxicillin-clavulanic acid, gentamicin, cefotaxime, ceftazidime, ceftriazone, sulphamethoxazole, tetracycline and ampicillin were employed while fungi isolates were tested against five common antifungal-griseofulvin, nystatin, ketoconazole, fluconazole and clotrimazole. The Multiple Antibiotic Resistance Index (MARI) of each of the isolated bacteria was obtained following the standard method. Result: The antimicrobial susceptibility-resistance profile of the bacteria isolates revealed that most of the bacteria were sensitive to ciprofloxacin, ofloxacin, gentamicin, and ceftriaxone, On the other hand, a good number of the isolates demonstrated high level of resistance to common antibiotics like Ampicillin, amoxycillin-clavulanic acid, trimethoprimsulphamethoxazole, and moderate level of resistance to Tetracycline, and some of the third generation cephalosporins - ceftazidime and cefotazime. Multiple Antibiotic Resistance Index (MARI) evaluation revealed that most of the isolates were resistance to more than fifty percent (50%) of the number of antibiotics used. The fungal isolates were susceptible to nystatin, ketoconazole and clotrimazole, resistance to fluconazole and high resistance recorded against griseofulvin. Conclusion: The results of this study revealed that the herbal medications can serve as a trail of spread of antibiotic-resistance genes.

Adverse Drug Reactions Induced by Anti-infectives:Analysis of 657 Cases / 中国药房

OBJECTIVE:To investigate the characteristics and regularities of adverse drug reactions(ADR) induced by anti-infective drugs in our hospital.METHODS:657 ADR cases induced by anti-infective drugs collected by the ADR monitoring center in our hospital in 2006 were classified and analyzed.RESULTS:13 categories(49 kinds) of anti-infective drugs were involved in the total 657 ADR cases.Of which,those patients aged above 60 years accounted for 30.14%.The ADR were chiefly induced by quinolones,followed by cephalosporins and penicillins etc,which chiefly manifested as lesion of skin and its accessories(53.12%),followed by the lesions of digestive system and nervous system etc.CONCLUSION:Multiple factors contributed to the ADR,to which great importance should be attached so as to reduce the incidence of ADR induced by anti-infectives.

ADR Reports:Analysis of 93 Cases in Our Hospital / 中国药房

OBJECTIVE: To study the regular pattern and characteristics of adverse drug reactions(ADR) in our hospital.METHDOS: 93 ADR cases collected from Jan.1,2006 to Dec.31,2006 in our hospital were analyzed statistically in respect of drug categories,Sex and age distribution,routes of administration,organs and systems involved and clinical manifestations etc.RESULTS: Of the 93 ADR cases,the patients aged above 60 showed the highest proportion(47.3%);31.2% were induced by anti-infective drugs;69.9% were induced through intravenous way;and damages of skin and its appendants were the most common manifestations(35.5%).CONCLUSION: Anti-infective drugs should be used rationally to avoid or reduce the occurrence of ADR.

Analysis of the Use of Anti-infectives in6Hospitals of Guang'an City from 2001 to 2004 / 中国药房

OBJECTIVE:To provide references for the application and management of anti-infectives.METHODS:Data on sale volume,DDDs etc.of anti-infection drugs in6hospitals of Guang'an city from2001to2004were statistically analyzed.RESULTS:The DDDs of oral lomefloxacin dominated the first or2nd places for the4years;The DDDs rank orders of isoniazid and rifampin were No.4and No.5respectively in the4years;The DDDs of penicillin for injection dominated the first place on the injectable preparation lists(2001～2003);The latecomer levofloxacin assumed the tendency of surpassing the early starters not only in sale volume but also the DDDs.CONCLUSION:The proportion for anti-infectives in sales volume to the sum total drug consumption of the above mentioned area were close to those of the other medical institutions in southwest area,there are less new drug varieties and the grade of drugs used in the area was low.

Distribution of Pathogens and Their Antibiotic Resistance / 中华医院感染学杂志

OBJECTIVE To understand the clinical hospital pathogens and the distribution of spectrum resistance trends in the past four years to control nosocomial infection and provide reasonable basis for therapy.METHODS From 2004 to 2007 the pathogens were isolated,identified and taken drug sensitivity tests.RESULTS During the 4 years,3176 isolates were collected.Gram positive(G+) cocci accounted fro 44.23%,?-hemolytic streptococcus,Staphylococcus aureus,Streptococcus pneumonial,coagulase-negative Staphylococcus and Enterococcus faecalis were the main pathogens.Gram-negative(G-) bacilli accounted for 40.65%,in order were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Moraxella catarrhalis.Fungi(Candida albicans) accounted for 16.30%.G+ cocci and G-bacilli showed different levels of resistance.Most of G+ cocci were sensitive to vancomycin.The G-bacilli were sensitive to imipenem.CONCLUSIONS Strengthening the monitoring of the clinical pathogenic bacteria and drug resistance is of great significance to control nosocomial infection and treatment.

Application of Question-asking Approach in the Classroom Teaching of“Rational Administration of Anti-infectives” / 中国药房

OBJECTIVE:To apply the question-asking approach to the teaching of“Rational Administration of Antiin?fectives”for medical undergraduates.METHODS:Teaching design was conducted before classroom teaching,which included designing questions and making two sets of test papers(the questions were the same for the two sets)for book-open written examination,interactive question-asking teaching approach was applied in classroom teaching process.RESULTS:The class?room was very active and students’enthusiasm of learning was greatly motivated,students’average score of this subject in?creased from50.2in the pretest to96.6at the end of classroom learning,which was of significant difference(P

Analysis of Drugs Used by Inpatients Undergoing Oral and Maxillofacial Surgery in Our Hospital in 2006 / 中国药房

OBJECTIVE:To investigate the use of drugs in the inpatients undergoing oral and maxillofacial surgery in our hospital for references of rational drug use.METHODS:The drugs used in the inpatients undergoing oral and maxillofacial surgery in our hospital during 2006 were analyzed statistically in respect of sum of money,the quantities of drugs and DDDs etc.RESULTS:Narcotics,anti-infectives and drugs affecting electrolyte balance and acid-base balance ranked among the first in terms of consumption sum,accounting for 30.18%,24.60%,and 16.12%,respectively.Leading the first 3 places in terms of co-nsumption sum were propofol injection,cefuroxime sodium for injection and sodium chloride injection.Vitamin C injection,benz-ylpenicillin sodium for injection and sodium chloride injection ranked at the top 3 in terms of DDDs.CONCLUSION:Only a few kinds of drugs were used for the inpatients undergoing oral and maxilla facial surgery in our hospital.Of which,narcotics,anti-infectives and drugs affecting electrolyte balance and acid-base balance were predominantly used,and intravenous administration was the chief route of administration.It is necessary to strengthen the rational use of anti-infectives in our hospital.

Impact of Drug Price Limits Policy on the Consumption of Anti-infectives in Our Hospital / 中国药房

OBJECTIVE:To investigate the impact of the drug price limits policy on the consumption of anti-infectives in our hospital.METHODS:The consumption sum and DDDs of the chief categories of anti-infectives in our hospital before and after the adoption of drug price limits policy(between Oct.,2004 and Sept.,2005 and between Oct.,2005 and Sept.,2006)were analyzed statistically.RESULTS & CONCLUSION:Both DDDs and consumption sum of the chief categories of anti-infectives in our hospital decreased markedly since the adoption of drug price limits policy.