Assuntos
Anti-Infecciosos/uso terapêutico , Haemophilus influenzae/efeitos dos fármacos , Streptococcus pneumoniae/efeitos dos fármacos , Anti-Infecciosos/farmacologia , Ensaios Clínicos como Assunto , Resistência Microbiana a Medicamentos , Fluoroquinolonas , Infecções por Haemophilus/tratamento farmacológico , Humanos , Pneumonia Pneumocócica/tratamento farmacológicoRESUMO
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Assuntos
Humanos , Streptococcus pneumoniae , Pneumonia Pneumocócica , Fluoroquinolonas , Anti-Infecciosos , Resistência Microbiana a Medicamentos , Haemophilus influenzae , Infecções por HaemophilusRESUMO
OBJECTIVE: To identify the antibiotic prescriptions and evaluate their suitability for the infectious conditions treated at a Primary Care Centre. DESIGN: A prospective observation study. SETTING: La Mina Primary Care Centre. Sant Adrià de Besòs (Barcelona). PATIENTS AND OTHER PARTICIPANTS: The on-demand visits of patients over 14 to the General Medicine and Emergency clinics between June 1991 and May 1992 provided the data through a simple multi-stage random sample. MEASUREMENTS AND MAIN RESULTS: On the basis of the clinical notes, these variables were recorded: age, gender, diagnosis, the antibiotic prescribed and its manner of administration. The indication and choice of treatment was assessed in line with previously established criteria, as well as whether the antibiotic was first-choice in Primary Care. Infections treated in hospital or by specialists, non-bacterial cutaneous infections and Conjunctivitis were excluded. Out of 2,523 people examined, 474 presented infectious conditions (18.8%); the most common of these were infections of the upper respiratory tract (46.4%) and acute Bronchitis (17.3%). An antibiotic was prescribed in 206 cases (43.3%). The most used antibiotics were: Amoxicillin (41.5%), Penicillin (19.0%), Cloxacillin (11.2%), Erythromycin (10.2%) and Pipemidic Acid (7.8%). They were orally taken in 89.4% of cases. 92.3% of the antibiotics were first-choice. Overall fitness of treatment was 86.3% (56.5% unnecessary and non-prescribed treatment; and 29.7% necessary and using the recommended antibiotic). The least suitable treatment was observed for cases of acute Bronchitis without any risk factors. CONCLUSIONS: Prescriptions are adjusted to the recommendations on antibiotic policy in Primary Care, although less suitable treatment was observed for acute Bronchitis. The importance of applying a methodology based on objective criteria, in order to make a qualitative analysis in studies on the use of medication, is highlighted.
Assuntos
Antibacterianos/uso terapêutico , Doenças Transmissíveis/tratamento farmacológico , Uso de Medicamentos , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosAssuntos
Doenças Urológicas , Adulto , Idoso , Antibacterianos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/terapia , Incontinência Urinária/diagnóstico , Incontinência Urinária/terapia , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária por Estresse/terapia , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Urodinâmica , Urografia , Doenças Urológicas/diagnóstico , Doenças Urológicas/terapiaAssuntos
Amnésia/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de TempoRESUMO
We present 5 cases of sensitive-motor hereditary neuropathies which were detected or controlled in primary care. Four patients had Charcot-Marie-Tooth disease (type I) and the remaining patient is a carrier of Dejerine-Sottas disease (type III). Regardless of the age of presentation of the disease, the evolution has been slow but steady in all cases. Talipes cavus is the most frequent secondary deformity. An electroneuromyographic study and a neural biopsy were the complementary diagnostic tests used. Three of the patients presented family antecedents. We believe that early diagnosis, family study and genetic advice are of great importance in primary care.
