ABSTRACT
Resumen Introducción: La relevancia de los medicamentos para la salud depende de su calidad, acceso y correcto uso. Objetivos: Determinar el valor terapéutico potencial de los antibióticos no incluidos en la lista de medicamentos esenciales (LME) de la Organización Mundial de la Salud pero que forman parte del Cuadro Básico de Medicamentos (CBM) de la Secretaría de Salud de México y categorizarlos por su valor intrínseco. Método: Análisis descriptivo de los antibióticos no incluidos en la LME de la Organización Mundial de la Salud 2013, revisión de la literatura para obtener evidencia de eficacia y seguridad y aplicación de escala de calidad y de valor intrínseco. Resultados: Se identificaron 452 resúmenes para 19 antibióticos, se eliminaron 56.9 %. In extenso se revisaron 195 ensayos clínicos; 37.9 % fueron de calidad y se determinó valor intrínseco; 54 % fueron estudios de superioridad y 46 % de no inferioridad o equivalencia; 32 % de los antibióticos fueron clasificados sin valor intrínseco y aproximadamente 50 % fueron dudosos. Conclusión: Una elevada proporción de antibióticos del CBM tuvo valor intrínseco dudoso o nulo, lo que favorece su uso inapropiado, resistencia bacteriana y coloca a la población en riesgo.
Abstract Introduction: The relevance of medications for health depends on their quality, accessibility and appropriate use. Objective: To determine the potential therapeutic value of antibiotics that are not included in the World Health Organization Essential Medicines List (EML) but that are part of the National Essential Medicines List (NEML) of the Mexican Ministry of Health, and categorize them according to their intrinsic value. Method: Descriptive analysis of antibiotics not included in the 2013 World Health Organization EML; literature review to obtain efficacy and safety evidence; and application of quality and intrinsic value scales. Results: Four hundred and fifty-two abstracts were identified for 19 antibiotics; 56.9 % were excluded; 195 clinical trials were reviewed in full-text articles, out of which 37.9 % were of good quality, and intrinsic value was determined; 54 % were superiority studies, whereas 46 % were non-inferiority or equivalence studies; 32 % of the antibiotics were classified without intrinsic value and nearly 50 % were inconclusive. Conclusion: An elevated proportion of antibiotics of the NEML had uncertain or no intrinsic value, which favors their inappropriate use, bacterial resistance and puts the population at risk.
Subject(s)
Humans , Drugs, Essential , Inappropriate Prescribing/statistics & numerical data , Anti-Bacterial Agents/administration & dosage , Mexico , Anti-Bacterial Agents/adverse effectsABSTRACT
OBJECTIVE: To analyze the variation of the anticancer drug list in the National Essential Medicines List (NEML-2018) and compare with the WHO Essential Model List (WHO-EML-2017) considering the epidemic characteristics and current national conditions, in order to provide the reference and advice for the revision of NEML in the future. METHODS: The category, content, formulation, dosage forms, medicines for children and indication for use of anticancer drug list between the NEML-2018 and WHO-EML-2017 were compared, and the deficiency existing in the NEML-2018 was analyzed. RESULTS: Compared with the NEML-2012, the category and content of the anticancer drug list have been improved in the 2018th edition, which is more reasonable for clinical request. However, disadvantages still exist in the aspect of the content, formulation, dosage forms, medicines for children and indication for use compared with the WHO-EML-2017. CONCLUSION: Although the rationality of the category and content has been improved in the NEML-2018, it still needs to be further improved compared with the WHO-EML-2017, which provides guidance and indication for the revision of anticancer drug list of the NEML in the future.