Change of Antibiotic Sensitivities to Causative Organisms of Urinary Tract Infection in Out Patients 2 years Before and After the Separation of Prescription and Dispensing Medicines

BACKGROUND: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult .Therefore,a new system that separated prescribing and dispensing medicine began on July 1,1997 to prevent overuse and misuse of medicine.We studied to evaluate changes of antibiotic sensitivities to causative microorganisms of urinary tract infection 2 years before and after the new medical system. METHODS: During each 2 years before and after the new medical system,we analyzed antibiotic sensitivities of causative microorganisms for urinary tract infection among the 447 out-patients who visited a hospital in GangNeung.The diagnosis of urinary tract infection was based on greater than 105 CFU (Colony For Unit)per ml.urine. RESULTS: The most common pathogenic microorganisms as E.coli (76.5%),followed by Klebsiella pneumoniae (5.1%),and Proteus mirabilis (3.6%)in urine culture. A first generation cephalosporin,cephalothin,against E.coli, had more significant sensitivity after the introduction of the new medical system (52.6%)than before (33.9%),especially in the 80th decade (P=0.023) and in females (P<0.001).Also,trimethoprim/sulfamethoxazole against E.coli showed signifcant improving sensitivity (P=0.025). CONCLUSION: There was little change of antibiotic sensitivity of urinary tract infection in out-patients before and after the new medical system in cephalothin and trimethoprim/sulfamethoxazole against E.coli. The change of antibiotic sensitivities will require further observation for a longer term after the introduction of the new medical system.

A Survey on the Knowledge, Attitude, and Practice of Separation of Prescribing and Dispensing Medicine: Among Patients of Family Medicine Clinic in an University Hospital

BACKGROUND: In Korea, the separation of prescribing and dispensing medicine was finally accepted as a medical policy in July, 2000, after a long period of discussion and study which was started in 1963. Now a year after the policy started, we investigated the knowledge, attitude, and practice of separation of prescribing and dispensing medicine. METHODS: Information, concerning whether the policy was effectively carried out and well understood, were gathered from 383 patients, who visited an university hospital from August 20 to September 1, 2001. RESULTS: The results revealed that 73.1% of the subjects knew the policy precisely. However, only 1.6% of them could answer all four questions on the purpose of the policy. The old-aged, the low educated, the low socioeconomic groups and the residents in agricultural area revealed poor understanding of the policy (P<0.05). Among the total, 74.9% showed negative response toward the policy. Time and cost increment were 75.7% and 75.2%, respectively. Among them 61.1% revealed negative attitude towards continuance the policy and 93.2% revealed dissatisfaction of the policy. CONCLUSION: The knowledge of the policy was relatively high. However, negative attitudes prevailed on the continuance of the policy. Therefore, more solutions and better strategies for the problems of prescribing and dispensing medicine would be needed.