ABSTRACT
Objective To evaluate the rationality of antibiotic use in the outpatient and emergency departments in some class 3A hospitals in China through International Network for Rational Use of Drugs (INRUD).Methods The antibiotic prescriptions were collected from the outpatient and emergency departments in 78 class 3A hospitals of 25 provinces through INRUD during 2014-2015.The basic information of the antibiotic prescriptions and the prescriptions rationality were evaluated.Results A total of 447 894 prescriptions of antibiotics were analyzed.From 2014 to 2015,the qualified rate the prescriptions increased from 91.52％ to 93.08％,and the antibiotic use rate was similar (11.72％ and 12.04％).The major irrational prescription type was inappropriate prescription,including inappropriate indication (32.42％,34.02％) and inappropriate usage and dosage (24.22％,18.56％).Conclusions Totally,the antibiotic use in the outpatient and emergency department reached the standard in China.However,the use of antibiotics didn' t meet the national requirements in some area.It is necessary to promote the rational use of antibiotics.
ABSTRACT
Objective To evaluate the rationality of antibiotic use in the outpatient and emergency departments in some class 3A hospitals in China through International Network for Rational Use of Drugs (INRUD).Methods The antibiotic prescriptions were collected from the outpatient and emergency departments in 78 class 3A hospitals of 25 provinces through INRUD during 2014-2015.The basic information of the antibiotic prescriptions and the prescriptions rationality were evaluated.Results A total of 447 894 prescriptions of antibiotics were analyzed.From 2014 to 2015,the qualified rate the prescriptions increased from 91.52％ to 93.08％,and the antibiotic use rate was similar (11.72％ and 12.04％).The major irrational prescription type was inappropriate prescription,including inappropriate indication (32.42％,34.02％) and inappropriate usage and dosage (24.22％,18.56％).Conclusions Totally,the antibiotic use in the outpatient and emergency department reached the standard in China.However,the use of antibiotics didn' t meet the national requirements in some area.It is necessary to promote the rational use of antibiotics.
ABSTRACT
Introduction: The programs of rational use of antibiotics are designed to optimize antimicrobial therapy and minimize the emergence of bacterial resistance. In order to optimize the use of antibiotics we implemented an educational program based on the application of a checklist criteria for the rational use of these drugs. Method: We performed a cohort study unpaired in the Department of Internal Medicine, during three months. We compared a prospective cohort (A) which used a checklist, with a retrospective cohort (B) in wich prescription was based on usual clinical practice. Results: We included 227 prescriptions of antibiotics. In cohort A compared to B, there was a higher proportion of switch to oral antibiotics agents and adjustment of the antimicrobial therapy to the susceptibility in the antibiogram and reduced use of associated antibiotics. Total antibiotic consumption was 117.7 DDD/100 bed-days (Defined Daily Doses). Consumption in cohorts A and B was 46.1 DDD/100 bed-days and 71.6 DDD/100 bed-days (reduction, 35.6%). There was also a reduction in consumption of ceftriaxone, ceftazidime, quinolones, vancomycin and carbapenems. Costs were reduced by 55%. There was no difference in the average hospital stay. Conclusions: The implementation of an educational strategy based on a checklist allowed the optimum use of antibiotics.
Introducción: Los programas de uso racional de antimicrobianos tienen la finalidad de optimizar la terapia antimicrobiana y minimizar la aparición de resistencia bacteriana. Con el objetivo de optimizar el uso de antimicrobianos se implementó un programa educativo basado en la aplicación de una lista de verificación (check list) conteniendo criterios establecidos de uso racional de estos fármacos. Método: Se realizó un estudio de cohortes no pareadas en el Departamento de Medicina Interna, durante tres meses. Se comparó una cohorte prospectiva (A) en que se aplicó la lista de verificación, con una cohorte retrospectiva (B) con prescripción de acuerdo a la práctica clínica habitual. Resultados: Se incluyeron 227 prescripciones de antimicrobianos. En la cohorte A, hubo mayor proporción de paso a vía oral y adecuación del antimicrobiano al antibiograma y menor uso de asociación de antimicrobianos, con respecto a la cohorte B. El consumo total de antimicrobianos fue de 117,7 DDD/100 días-cama (Dosis Diaria Definida). El consumo en las cohortes A y B fue de 46,1 DDD/100 días-cama y 71,6 DDD/100 días-cama respectivamente (reducción de un 35,6%). También hubo una reducción en el consumo de ceftriaxona, ceftazidima, quinolonas, vancomicina y carbapenem. Los costos se redujeron en 55%. No hubo diferencias en la estadía media hospitalaria. Conclusiones: La aplicación de una estrategia educativa basada en una lista de verificación permitió optimizar el uso de antimicrobianos.
Subject(s)
Humans , Anti-Bacterial Agents/therapeutic use , Hospitals, University/statistics & numerical data , Practice Patterns, Physicians' , Cohort Studies , Internal Medicine , Pilot Projects , Program Evaluation , Prospective Studies , Retrospective StudiesABSTRACT
Os hábitos prescritivos e o processo de dispensação de medicamentos são determinantes para o uso racional de antibióticos. Com o objetivo de descrever o perfil de prescrição e dispensação de antibióticos usados por crianças, foram analisadas 100 prescrições pediátricas que continham antibióticos aviadas em uma Unidade Básica de Saúde do município de Ijuí/RS de abril a dezembro de 2009. Observou-se prevalência de meninas (53%) com idades entre quatro e seis anos (39%) e que receberam prescrição de azitromicina (45%) e amoxicilina (40%). Verificou-se em média 3,5±8,71 medicamentos por prescrição devido à associação de analgésicos, anti-inflamatórios, antitérmicos e antialérgicos aos antibióticos prescritos. Nenhuma prescrição apresentou todos os itens avaliados: o endereço do usuário e advertências sobre o uso dos medicamentos prescritos não foram encontrados nas prescrições analisadas e apenas 5% estavam legíveis. Já posologia, denominação genérica, nome completo do usuário e dados do prescritor foram verificados em todas as prescrições. Sugere-se a qualificação das equipes de saúde a fim de atuarem nos processos de prescrição e dispensação de medicamentos e implantarem ações educativas sobre uso, guarda e descarte de antibióticos junto aos usuários. O acompanhamento farmacoterapêutico pode ser uma estratégia efetiva para prevenir resistência microbiana e reações adversas a antibióticos.
Prescribing habits and the process of dispensing medicines are determining factors for the rational use of antibiotics. With the objective of describing the profile of antibiotic prescription and dispensing for children, 100 pediatric prescriptions containing antibiotics, issued at a district Primary Health Center in the city of Ijuí, from April to December 2009, were analysed. There was a prevalence of girls (53%), aged between four and six years (39%), who were prescribed azithromycin (45%) and amoxicillin (40%). The mean number of medicines per prescription was 3.5±8.71, owing to the combination of analgesic, anti-inflammatory, antipyretic and anti-allergy drugs with the antibiotics prescribed. Not one prescription included all the items assessed: the patient?s address and warnings about the use of prescribed medications were not found in the prescriptions analyzed and only 5% were legible. On the other hand, dosage, generic name, full name of the user and the prescriber data were found in all prescriptions. It is suggested that health teams be qualified to work in the processes of prescription and dispensing of medicines and to conduct educational activities on the use, storage and disposal of antibiotics among the users. Pharmacotherapeutic follow-up can be an effective strategy to prevent bacterial resistance and adverse reactions to antibiotics.