RESUMO
Bacterial resistance is a major concern and the proper use of antibiotics is a global public health priority. Inappropriate use of antibiotic therapy can have serious ecological and pharmaco-economic consequences. The objective of our work was to study the reevaluation of probabilistic antibiotherapy in the burns intensive care unit. A prospective study concerning the clinical-biological reassessment of antibiotic therapy was set up in the burns intensive care unit at the Military Hospital Instruction Mohammed V of Rabat. The data was collected over a period of 6 months, from June 1, 2017 to November 30, 2017. During the study period, 142 patients received an antibiotic prescription. Only 68 serious hospitalized septic patients were included in our study. The population was predominantly male (75%). The average age of our patients was 36 years, ranging from 15 to 56 years old. The average length of hospitalization in intensive care was 10 days. Of the 68 antibiotic regimens implemented, the reassessment rate was 72.06%, with 75% justified treatment rates, and 25% not justified. Therapeutic de-escalation was performed in 8 cases (11.76%), when it could have been performed 25 times (36.76%). This is justified by the nosocomial context of the burns intensive care unit with a bacterial ecosystem of BMR type (Klebsiella pneumoniae, Acinetobacter baumanii, Escherichia coli and Staphylococcus coagulase negative), which restricts the choice of antibiotic therapy to some molecules. Clinico-biological re-evaluation of antibiotic therapy is essential to fight the misuse of antibiotics. This study allowed us to evaluate the re-evaluation practices of antibiotic therapy at 48-72h in burns resuscitation. Subsequently, several actions were carried out: the appointment of a pharmacist in antibiotherapy within the Pole Pharmacy of the Mohammed V Military Hospital in Rabat, the activation of an Anti-Infectious Committee and the dispensing of antibiotics via Pyxis MedStation.
RESUMO
INTRODUCTION: Dental caries represents a problem of public health in Morocco and the reduction of this pathology is a priority of the Ministry of Health. The use of fluoride toothpastes is, at present, recognized as being an effective means for the prevention of dental caries. MATERIAL AND METHODS: [corrected] The aim of our study was to verify the correspondence of the information marked on packagings with the international standards, but also to determine using potentiometry the quantity of fluorine presents in toothpastes marketed in Morocco from three origins: pharmacies, hypermarkets and ambulant sellers. RESULTS: The study concerned 56 toothpastes, 73.2% of toothpastes respect the standards of the concerning WHO dates of manufacturing and lapsing. The type of fluoride was specified only on 67.8% of packagings and the used concentration of fluoride was indicated only in 62.5% of the tested samples. For 56 studied toothpastes, the results revealed that if we take into account standards recommended by the WHO and the European Union, only 57.1% of toothpastes could have an effect dental caries. CONCLUSION: The results of this study show that there is a real need of quality control of fluoride toothpastes sold in Morocco especially those of the itinerant market.
