scholarly journals Prescribing Patterns of Antibiotics for the Self-Treatment of Travelers’ Diarrhea in Global TravEpiNet, 2009–2018

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Aditya R Gandhi ◽  
Sowmya R Rao ◽  
Lin H Chen ◽  
Michael D Nelson ◽  
Edward T Ryan ◽  
...  
Keyword(s):  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
The Self ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Empiric Antibiotics ◽  
Before And After ◽  
Time Series Analyses ◽  
Rate Of Decline

Abstract Background International travelers are often prescribed antibiotics for self-treatment of travelers’ diarrhea (TD), but the benefits and risks of antibiotics are debated. We assessed the prescribing patterns of empiric antibiotics for TD in international travelers evaluated at Global TravEpiNet (GTEN) sites (2009–2018). Methods We performed a prospective, multisite cross-sectional study regarding antibiotic prescriptions for the self-treatment of TD at 31 GTEN sites providing pretravel consultations to adult international travelers. We described traveler demographics, itineraries, and antibiotic(s) prescribed. We used multivariable logistic regressions to assess the association of year of consultation with antibiotic prescribing (yes/no) and class (fluoroquinolones vs azithromycin). We performed interrupted time-series analyses to examine differences in prescribing before and after the Food and Drug Administration (FDA) warning on fluoroquinolones (July 2016). Results Antibiotics were not prescribed in 23 096 (22.2%) of 103 843 eligible pretravel GTEN consultations; azithromycin and fluoroquinolones were most frequently prescribed. Antibiotic prescribing declined significantly each year between 2009 and 2018 (odds ratio [OR], 0.84; 95% CI, 0.79–0.89), as did fluoroquinolone prescribing, relative to azithromycin (OR, 0.77; 95% CI, 0.73–0.82). The rate of decline in fluoroquinolone prescribing was significantly greater after the FDA fluoroquinolone warning (15.3%/year) than before (1.1%/year; P < .001). Conclusions Empiric antibiotics for TD were prescribed in >75% of pretravel GTEN consultations, but antibiotic prescribing declined steadily between 2009 and 2018. Fluoroquinolones were less frequently prescribed than azithromycin, especially after the 2016 FDA fluoroquinolone warning. Emphasis on the risks of antibiotics may influence antibiotic prescribing by providers for empiric treatment of TD.

scholarly journals Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245902
Author(s):  
Kristina Skender ◽  
Vivek Singh ◽  
Cecilia Stalsby-Lundborg ◽  
Megha Sharma
Keyword(s):  
Design Patterns ◽  
Central India ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Defined Daily Doses

Background Frequent antibiotic prescribing in departments with high infection risk like orthopedics prominently contributes to the global increase of antibiotic resistance. However, few studies present antibiotic prescribing patterns and trends among orthopedic inpatients. Aim To compare and present the patterns and trends of antibiotic prescription over 10 years for orthopedic inpatients in a teaching (TH) and a non-teaching hospital (NTH) in Central India. Methods Data from orthopedic inpatients (TH-6446; NTH-4397) were collected using a prospective cross-sectional study design. Patterns were compared based on the indications and corresponding antibiotic treatments, mean Defined Daily Doses (DDD)/1000 patient-days, adherence to the National List of Essential Medicines India (NLEMI) and the World Health Organization Model List of Essential Medicines (WHOMLEM). Antibiotic prescriptions were analyzed separately for the operated and the non-operated inpatients. Linear regression was used to analyze the time trends of antibiotic prescribing; in total through DDD/1000 patient-days and by antibiotic groups. Results Third generation cephalosporins were the most prescribed antibiotic class (TH-39%; NTH-65%) and fractures were the most common indications (TH-48%; NTH-48%). Majority of the operated inpatients (TH-99%; NTH-97%) were prescribed pre-operative prophylactic antibiotics. The non-operated inpatients were also prescribed antibiotics (TH-40%; NTH-75%), although few of them had infectious diagnoses (TH-8%; NTH-14%). Adherence to the NLEMI was lower (TH-31%; NTH-34%) than adherence to the WHOMLEM (TH-65%; NTH-62%) in both hospitals. Mean DDD/1000 patient-days was 16 times higher in the TH (2658) compared to the NTH (162). Total antibiotic prescribing increased over 10 years (TH-β = 3.23; NTH-β = 1.02). Conclusion Substantial number of inpatients were prescribed antibiotics without clear infectious indications. Adherence to the NLEMI and the WHOMLEM was low in both hospitals. Antibiotic use increased in both hospitals over 10 years and was higher in the TH than in the NTH. The need for developing and implementing local antibiotic prescribing guidelines is emphasized.

scholarly journals Antimicrobial prescribing patterns in surgical inpatient of tertiary care hospital in Eastern India

2019 ◽  
Vol 8 (8) ◽  
pp. 1902
Author(s):  
Sumit Kumar Gupta ◽  
Siddhartha Ghosh
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Beta Lactam ◽  
Cross Sectional ◽  
Before And After ◽  
Surgery Department

Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.

scholarly journals Antibiotics prescribing patterns in medical wards of Yangon General Hospital, Myanmar

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Aye Thi Khaing ◽  
Nang Hla Hla Win
Keyword(s):  
General Hospital ◽  
Demographic Data ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Medical Wards ◽  
Pro Forma

Introduction: Irrational and inappropriate prescribing of antimicrobial is common in hospitals and contributes to the development of antibiotic resistance in clinical practice. In Myanmar, there is insufficient information concerning antibiotics prescribing patterns in some hospitals. Therefore, the aim of this study was to determine the prescribing patterns of antibiotics in various infections. Methods: A descriptive cross-sectional study was carried out over a 3- month period in the medical wards of Yangon General Hospital. A total 1054 patients who were prescribed with antibiotics for post-admission day were selected. Relevant demographic data, discharge diagnosis, antibiotic prescribing patterns and outcomes of the patients were collected through pro-forma. Results: The result revealed that the antibiotics prescribing rate in Yangon General Hospital was 49%. Amongst the major indications included acute gastroenteritis (10%), chest infections (6.8%), skin and soft tissue infections (6.5%), pneumonia (6.1%) and spontaneous bacterial peritonitis (6.0%). The most frequently prescribed antibiotics were combination of aminopenicillin with beta lactamase inhibitors (29.4%), metronidazole (28.2%), ceftriaxone (24.4%), azithromycin (15.2%) and cefixime (12.8%). The majority of the patients were discharged from hospital (73.7%) whereas the expired population was 8.6%. Conclusions: This study offers useful information in developing antibiogram for medical wards of Yangon General Hospital, Myanmar. The findings of this study could contribute to improvement in the treatment outcomes.

scholarly journals Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; a case study in Iran

2020 ◽  
Author(s):  
Mohammad Ranjbar ◽  
Hassan Jafari ◽  
Mohammad Baziyar ◽  
Mohsen Pakdaman ◽  
Vahid Pirasteh
Keyword(s):  
Performance Indicators ◽  
Average Length ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Health Coverage ◽  
Monthly Basis ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Before And After

Abstract Introduction: Health systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. Methods: The present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. Findings: The implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).Conclusion: Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

scholarly journals Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

10.3823/845 ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 15
Author(s):  
Muhammad Umer Nadeem ◽  
Ram Bahadur Dhami ◽  
Krishna Prasad Dahal ◽  
Devi Ram Pokharel ◽  
Anil Kumar Singh ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescription Rate ◽  
Sectional Study ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Antimicrobial Prescribing ◽  
Private And Public ◽  
Antimicrobial Prescription

Objective The purpose of this cross-sectional study conducted in different private and public sector hospitals of the major cities of Nepal and Pakistan was to compare and evaluate the antibiotic prescribing patterns. Methodology  The data was collected based on prescriptions received from different hospitals of Lahore, Pakistan and Kathmandu, Nepal without much interaction with the patients. Results Out of a total of 272 patients, 111 (40.8%) patients from Nepal and 161 (59.19%) patients from Pakistan were prescribed with 447 antibiotics. In both countries, out of total antibiotics prescribed, 42.30% were 3rd generation cephalosporins. Also, in Pakistan and Nepal, out of all the indications, 49.2% of the antibiotics were given in medical prophylaxis. Conclusion  In Pakistan, the antimicrobial prescription rate is comparatively higher than Nepal, and in both countries, there is a need of proper implementation of antibiotic prescribing guidelines for the prescription of antibiotics and the administration of antibiotics in medical prophylaxis.

Proposition 8 and Homophobic Bullying in California

2021 ◽  
pp. 49-56
Author(s):  
Mark L. Hatzenbuehler ◽  
Yishan Shen ◽  
Elizabeth A. Vandewater ◽  
Stephen T. Russell
Keyword(s):  
Protective Factor ◽  
Interrupted Time Series ◽  
School Level ◽  
Cross Sectional ◽  
Proposition 8 ◽  
Before And After ◽  
Homophobic Bullying ◽  
Quasi Experimental ◽  
Bisexual And Transgender ◽  
Time Series Analyses

BACKGROUND Bias-based bullying is associated with negative outcomes for youth, but its contextual predictors are largely unknown. Voter referenda that target lesbian, gay, bisexual, and transgender groups may be 1 contextual factor contributing to homophobic bullying. METHODS Data come from 14 consecutive waves (2001–2014) of cross-sectional surveys of students participating in the California Healthy Kids Survey (N = 4 977 557). Student responses were aggregated to the school level (n = 5121). Using a quasi-experimental design, we compared rates of homophobic bullying before and after Proposition 8, a voter referendum that restricted marriage to heterosexuals in November 2008. RESULTS Interrupted time series analyses confirmed that the academic year 2008–2009, during which Proposition 8 was passed, served as a turning point in homophobic bullying. The rate of homophobic bullying increased (blinear = 1.15; P , .001) and accelerated (bquadratic = 0.08; P , .001) in the period before Proposition 8. After Proposition 8, homophobic bullying gradually decreased (blinear = 20.28; P , .05). Specificity analyses showed that these trends were not observed among students who reported that they were bullied because of their race and/or ethnicity, religion, or gender but not because of their sexual orientation. Furthermore, the presence of a protective factor specific to school contexts among lesbian, gay, bisexual, and transgender youth (gay-straight alliances) was associated with a smaller increase in homophobic bullying pre–Proposition 8. CONCLUSIONS This research provides some of the first empirical evidence that public campaigns that promote stigma may confer risk for bias-based bullying among youth.

scholarly journals Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; A Case Study in Iran

2020 ◽  
Author(s):  
Mohammad Ranjbar ◽  
Hassan Jafari ◽  
Mohammad Baziyar ◽  
Mohsen Pakdaman ◽  
Vahid Pirasteh
Keyword(s):  
Performance Indicators ◽  
Average Length ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Health Coverage ◽  
Monthly Basis ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Before And After

Abstract IntroductionHealth systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. MethodsThe present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. FindingsThe implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).ConclusionBased on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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