Evaluation of appropriate antibiotic administration by general practitioners at the emergency department of a teaching hospital in Sanandaj, Iran

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

Tuberculosis peritonitis with features of acute abdomen in HIV infection

This case report introduces a 26-year-old male IV drug abuser with fever, abdominal pain and distension referred to the emergency ward. According to these findings, abdominal tenderness and involuntary guarding, an explorative laparotomy was performed. Multiple biopsies of omentum, peritoneum and liver were taken. Pathologic assessment of multiple biopsies confirmed intra-abdominal TB infection