ABSTRACT
The influence of an educational program on the diagnosis and treatment of pharyngotonsillitis was evaluated in three outpatient clinics in northern Israel during two periods. During both periods--1 January to 31 March 1988 (baseline phase) and 1 January to 31 March 1989 (study phase)--clinical data of all patients for whom antibiotics were prescribed were recorded on special forms, which included the patient's diagnosis and the antibiotic prescribed. In November 1988, 2 months before the study phase, two 1 h sessions on pharyngitis were given by the study physicians to the entire medical staff of two clinics (Clinics B and C), and written material was distributed. A third clinic (Clinic A) served as the control. A comparison of the prescribing habits during the two phases showed that during the study phase the total number of antibiotics prescriptions for pharyngitis declined significantly in Clinics B and C, while the percentage of prescriptions for penicillin V rose with the concomitant decline of amoxycillin. There were no significant changes in prescribing habits in the control clinic. These results show that a modest 2 h educational program involving direct contact with the entire medical staff of the community outpatient clinics can improve the diagnosis of pharyngotonsillitis and reduce both the inappropriate use of antibiotics in general, and the substitution of more expensive antibiotics for cheaper, equally effective ones.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Prescriptions , Education, Medical, Continuing , Pharyngitis/drug therapy , Streptococcal Infections/drug therapy , Adult , Ambulatory Care , Amoxicillin/therapeutic use , Humans , Israel , Middle Aged , Penicillin V/therapeutic use , Pharyngitis/diagnosis , Streptococcal Infections/diagnosis , Tonsillitis/diagnosis , Tonsillitis/drug therapyABSTRACT
An epidemic of more than 8000 cases of Shigella sonnei infection took place in four adjacent urban communities which share the same water supply. The epidemic was caused by massive faecal contamination of the drinking water due to a leak from a broken main sewage pipe into an adjacent drilled well. The infecting organism in most cases was S. sonnei colicine type 6, biotype A, which showed a high rate of multiple resistance to commonly used antibacterial drugs. Most of those affected were children less than 15 years of age. Among adults the attack rates were higher in women. Most cases were mild, only 91 patients being admitted to hospital. One 5-year-old child died.
Subject(s)
Disease Outbreaks , Dysentery, Bacillary/epidemiology , Shigella sonnei , Water Pollution , Water Supply , Adult , Ampicillin Resistance , Child, Preschool , Drug Resistance, Microbial , Dysentery, Bacillary/microbiology , Feces/microbiology , Female , Humans , Israel/epidemiology , Tetracycline ResistanceABSTRACT
A survey was carried out in two plants in Haifa, Israel on the prevalence of treated and controlled hypertension. In both plants hypertension treatment was being carried out by family physicians at regular family clinics. In factory A, after screening, a programme of follow-up and treatment by the plant doctor and nurse was introduced. In factory B all hypertensives continued to be referred to their family physician for treatment and follow-up. One year later all previously detected hypertensives were reassessed. The percentage of treated hypertensives had increased from 70.9% to 100% in factory A, and from 55.0% to 62.1% in factory B. The percentage of controlled hypertensives among those treated had increased from 52.7% to 83.7% in factory A, and from 28.0% to 38.9% in factory B. Thus, the percentage of all hypertensives who were controlled increased from 37.3% to 83.7% in Factory A and from 15.4% to 24.1% in Factory B. The introduction of on-site treatment and follow-up of hypertension by a doctor-nurse team was associated with marked improvement of all aspects of hypertensive care.
