Role of the microbiology laboratory in the cost-effective use of antimicrobics

1986 ◽  
Vol 5 (7) ◽  
pp. 49-52
Author(s):  
Charles W. Stratton
2014 ◽  
Vol 2 ◽  
pp. 319-322
Author(s):  
Vitaliy Moskalenko ◽  
Iryna Nizhenkovskaya ◽  
Elena Welchinska

Countries worldwide are facing similar healthcare problems.  Medicine develops new methods for treatment, and pharmaceutical companies invent more efficient products.  These technological advances are, however, expensive, and put a double-strain on public healthcare spending: the cost of sophisticated treatment keeps growing, and improved healthcare allows patients to live longer, thus requiring more treatment.  Budgetary constraints, however, require government to restrict expenditure.  These challenges have to be answered in the context of existing public healthcare systems, which, are well established and complex.  Healthcare reforms will necessarily reflect these characteristics, as well as the relative political weight of the partners.  Such reforms will most likely affect all partners involved in the provision and healthcare management, including social security institutions (state agencies, sickness funds, etc.), doctors, and other health professionals—pharmacists.  Currently one of most important strategic tasks of modernization of the system of higher education in Ukraine is the high quality education provided to pharmacists in order to satisfy the worldwide needs.Whatever specific reform will be adopted, the main goals are to make the system more efficient and, thus, more cost effective; and, because the first aspect will not sufficiently decrease the expenditure, it is necessary to limit the scope of public health care while maintaining a balance of benefits.  


PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 914-916
Author(s):  
Vincent A. Fulginiti

Although most pediatricians agree on the importance of teaching parents and children about health care, they may not succeed in patient education because of a lack of the requisite communication skills, inadequate printed materials to augment personal involvement, a tendency to substitute such materials for personal involvement, and inadequate compensation. Physician recognition of an obligation to teach is a requisite for effective education. Adjustment of current practices is essential: use of educational materials must be systematically incorporated, educational efforts must make effective use of time and be cost-effective. Information should be readily understood, parents given an opportunity to ask questions, and effectiveness of the education evaluated. Pediatricians must have a constant source of supplementary material to use in patient education. Videotapes and interactive computer programs should be considered for more effective communication. Residency programs must teach future pediatricians how to educate parents and children.


2019 ◽  
Vol 974 ◽  
pp. 583-588
Author(s):  
Alexander I. Danilov

The subject of the article is to give a full analysis of the cascade type layouts in elements strengthening design in bending by gluing the fiber reinforced polymer (FRP) materials on their surfaces’ applicability and effectiveness. The research objectives are the substantiation elements cascade method application reinforcement with adhesive joints. Materials and methods are revealed in a few variants of FRP-reinforcement with application of FEM simulation. A number of diagrams and tables represent the results. The results are defined in the cost-effective efficient method presentation of the bent elements strengthening to increase their bearing capacity reserves, the features of the bonded joint behavior, the equations and formulae for the glue joint analysis and design. Conclusions are formulated in depicting the “cascade” reflects, the features of the proposed strengthening design, the base element unloading, which is gradual with each successive element attached. The design examples are oriented on the adhesive joints’ application possibility analysis of attaching the FRP elements. The results suggest the effective use possibility of the adhesive joints to strengthen rather stiff, including steel, elements in bending. The cascade method eliminates the indispensability of highly expensive high-strength materials, thereby reducing the reinforcement structures cost.


2013 ◽  
Vol 1 (2) ◽  
pp. 54-57
Author(s):  
TM Ibrahim

INTRODUCTION: The role of blood cultures (BCs) in the management of community acquired pneumonia (CAP) has generated a lot of controversy among clinicians in recent times. The main objectives of this audit were to determine if BC results impact the choice of antibiotics, and hospital outcomes in CAP. MATERIALS AND METHODS: This was a retrospective study of adults with CAP treated in the ED of Goulbourn Valley Base Hospital, Shepparton in Australia from November 2010 to November 2011. RESULTS: Two hundred and twenty five patients were treated for CAP during the period in review with a mean age of 67.09±19.82 yrs and male:female of 1.5:1. 277 sets of BCs were performed and only 2.2% of the cases had true positive BCs .87% of the total cost of performing these BCs was spent on those with negative cultres.15.1% of the cases had their antibiotics changed during their hospitalization but the results of the BCs had no impact on the antibiotic change. Even though not statistically significant true positive BCs was associated with prolong length of hospital stay (7.6 ± 9.39 days vs 4.89 ± 3.24 days, p=0.44), and duration of IV antibiotic use (4.8±3.27 days vs 3.58±1.97 days, p=0.39). But the case fatality rate was much lower in those with positive BCs, (0 vs 5.7%,p< 0.05). Tachycardia (>120.4±12.46 bpm), neutrophilia (15.0± 8.16 /ul), and high CRP (326.4±146.32 ug/l) were predictors of true positive BCs. CONCLUSIONS: Routine BCs in the management of CAP is not cost-effective with large portion of the cost spent on cultures that returned negative result .Therefore it use show be limited to those likely to return positive cultures. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7408 Int J Infect Microbiol 2012;1(1):54-57


2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).


Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Julian F. Guest ◽  
Monica Panca ◽  
Erikas Sladkevicius ◽  
Nicholas Gough ◽  
Mark Linch

Background. Doxorubicin/ifosfamide is a first-line systemic chemotherapy for the majority of advanced soft tissue sarcoma (ASTS) subtypes. Trabectedin is indicated for the treatment of ASTS after failure of anthracyclines and/or ifosfamide; however it is being increasingly used off-label as a first-line treatment. This study estimated the cost effectiveness of these two treatments in the first-line management of ASTS in Italy, Spain, and Sweden.Methods. A Markov model was constructed to estimate the cost effectiveness of doxorubicin/ifosfamide compared to trabectedin monotherapy, defined as the cost per QALY gained, in each country.Results. First-line treatment with doxorubicin/ifosfamide resulted in lower two-year healthcare costs and more QALYs than first-line treatment with trabectedin monotherapy in all three countries. Probabilistic sensitivity analysis showed that at a cost per QALY threshold of €35,000, >90% of a cohort would be cost effectively treated with doxorubicin/ifosfamide compared to trabectedin monotherapy in all three countries.Conclusion. Within the model’s limitations, first-line treatment of patients with ASTS with doxorubicin/ifosfamide instead of trabectedin monotherapy affords a cost-effective use of publicly funded healthcare resources in Italy, Spain, and Sweden and is therefore the preferred treatment in all three countries. These findings support the recommendation that trabectedin should remain a second-line treatment.


1997 ◽  
Vol 10 (6) ◽  
pp. 398-411 ◽  
Author(s):  
Stephanie LaCalamita

The pharmacist can play a key role in the development of critical pathways for disease states with warfarin as a component of therapy. The pharmacist must be familiar with the complex therapeutic considerations involved with warfarin therapy. This paper will briefly review warfarin therapeutics and will discuss strategies for pharmacist involvement in development of critical pathways including warfarin therapy. Participation in the multidisciplinary planning of critical pathways provides an excellent opportunity to contribute to the efficient, safe, and cost-effective use of warfarin.


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