Rationality of Antimicrobial Prescriptions in Community Pharmacy Users.

BACKGROUND: Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs. METHODS AND FINDINGS: A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug. CONCLUSIONS: Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.

Seasonal variation of potential flavivirus vectors in an urban biological reserve in northeastern Brazil.

Although yellow fever (YF) has not been reported on the eastern coast of Brazil since 1942, there was a reemergence of dengue fever in Brazil in 1987 due to the reintroduction of Aedes aegypti (L.). To assess areas of potential risk for transmission of vector-borne diseases, a surveillance system was placed in a large Atlantic Forest reserve in Natal, Rio Grande do Norte, Brazil, where in 2004 unexplained epizootics were reported among marmosets. The etiologic agent causing the mortality in marmosets has not been identified. Wyeomyia bourrouli Lutz, Haemagogus leucocelaenus Dyar & Shannon, Ae. aegypti, Aedes albopictus (Skuse), Ochlerotatus scapularis Rondani, Ochlerotatus serratus Theobald, Ochlerotatus taeniorhynchus Wiedemann, Culex quinquefasciatus Say, and Limatus durhami Theobald were collected in the park and in the proximity of the households adjacent to the park. Seasonal abundance fluctuation was significant for Ae. aegypti, Ae. albopictus, Ochlerotatus scapularis (Rondani), and Hg. leucocelaenus. Eggs of Ae. aegypti, Ae. albopictus, and Hg. leucocelaenus were more frequently found at the conclusion of the rainy season. A significant negative correlation between the number ofAe. albopictus collected and temperature was observed (r = -0.50), i.e., for each 10C increase in temperature, the number of specimens collected decreased eight-fold. The findings reported herein reinforce the need for a sustainable arboviral surveillance program in this area to decrease the potential risk of emergence of vector borne diseases as YF.