Evaluation of the Use of Cefuroxime and Cefuroxime Axetil in an Intravenous—Oral Stepdown Program

1996 ◽  
Vol 30 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Suzanne C Malfair ◽  
Luciana Frighetto ◽  
Donna M Nickoloff ◽  
Shelagh M Martinusen ◽  
Peter J Jewesson
Keyword(s):  
Random Sample ◽  
Oral Therapy ◽  
Respiratory Tract Infections ◽  
Negative Impact ◽  
Tertiary Care ◽  
Cefuroxime Axetil ◽  
Oral Antibiotic ◽  
Primary Therapy ◽  
Canadian Hospital ◽  
Tract Infections

OBJECTIVE: To characterize cefuroxime and cefuroxime axetil use under the influence of a parenteral-to-oral (iv—po) stepdown program. DESIGN: Open single-center retrospective review. SETTING: Tertiary care teaching and referral Canadian hospital with 1100 beds. PATIENTS: a random sample of 78 patients receiving cefuroxime was compared with a random sample of 50 patients receiving iv—po cefuroxime stepdown. RESULTS: During the first 6 months following formulary introduction, 1535 patients received cefuroxime. Stepdown to any oral antibiotic occurred in 22% of patients. Cefuroxime axetil was used as the stepdown agent in 64% of these cases. In a comparison of nonstepdown courses with stepdown courses, some differences were apparent. Nonstepdown treatment courses were primarily prophylactic, whereas stepdown courses were typically initiated as primary therapy for the 10-day management of respiratory tract infections (p < 0.001). Conversion to oral therapy typically occurred on day 5 of parenteral therapy and continued for 5 days. Stepdown was considered possible in 46% of treatment courses in which this process did not happen. When stepdown did occur, it was considered timely in 64% of cases, unnecessarily delayed in 32%, and premature in 4% of treatment courses. Stepdown did not appear to be associated with a negative impact on patient outcome. Mean ± SD cost of drug therapy per day was less for the stepdown group (US $15.78 ± $5.97) than the nonstepdown group (US $25.47 ± $7.87; p < 0.001). CONCLUSIONS: As a result of this study we intend to maintain cefuroxime and cefuroxime axetil on the formulary and continue to judiciously promote the timely conversion to oral therapy.

Development of an Intravenous-to-Oral Route Conversion Program for Antimicrobial Therapy at a Canadian Tertiary Care Health Facility

1997 ◽  
Vol 31 (5) ◽  
pp. 564-570 ◽  
Author(s):  
Monique T Zamin ◽  
Monique M Pitre ◽  
John M Conly
Keyword(s):  
Internal Medicine ◽  
Oral Therapy ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Soft Tissue Infections ◽  
Intravenous Therapy ◽  
General Internal ◽  
Care Health ◽  
Internal Medicine Wards ◽  
Tract Infections

OBJECTIVE: To describe the effect of introducing a route conversion program on the prescribing of antimicrobials for the treatment of respiratory tract infections and skin/soft tissue infections in a sample population. DESIGN: Concurrent, pre- and postintervention study. SETTING: Four general internal medicine wards at The Toronto Hospital, a 1170-bed, tertiary care health center in Toronto, Ontario, Canada. PARTICIPANTS: Patients receiving antimicrobial therapy for respiratory tract infections and skin/soft tissue infections. INTERVENTION: Written guidelines and education sessions were presented to residents, interns, medical students, and pharmacists responsible for the care of patients admitted to four general internal medicine wards. MAIN OUTCOME MEASURES: Clinical and laboratory parameters related to the status of the infection were monitored prospectively and compared with the course of drug therapy, with consideration of the patient's ability to meet the criteria established in the guidelines. The number of days of intravenous therapy prescribed despite appropriateness of oral therapy was tallied. RESULTS: Twenty-seven patients (28 infections) were identified for inclusion in the 7-week preliminary audit, and 30 patients (32 infections) were included in the audit after the program, which continued for 5 weeks. Following implementation of the program, the number of days that intravenous therapy was continued despite the appropriateness of oral therapy was reduced from 41% to 26% of the total days of intravenous therapy prescribed. CONCLUSIONS: The program had a positive influence on antimicrobial prescribing behavior in the population studied. Strategies to ensure continued benefit from the program have been developed.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

scholarly journals Prescribing pattern of antibiotics in pediatric department of a tertiary care teaching hospital

2020 ◽  
Vol 9 (5) ◽  
pp. 782
Author(s):  
Nalini G. K. ◽  
Neelamma . ◽  
Prasanna Kumar D. G. ◽  
Deepak P. ◽  
Sahana G. N. ◽  
...  
Keyword(s):  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Age Group ◽  
Gastrointestinal Infections ◽  
Prescribing Pattern ◽  
Pediatric Department ◽  
Prescription Pattern ◽  
Tract Infections ◽  
A Prospective Study

Background: Prescription is an order from doctor for medicine. Rational use of medicines requires that "patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community". Irrational use of medicines is a major problem worldwide. This leads to serious morbidity and mortality also leads to reduction in the quality of treatment due to antibiotic resistance. Evaluation of prescribing pattern will help in minimizing adverse drug reactions, resistance among children. Also help to know the attitude of the physicians towards prescribing. Aim of the present study was to evaluate the prescription pattern of antibiotics in paediatric inpatients of Hassan institute of Medical Sciences.Methods: A prospective study, conducted among 110 patients below the age of 18 years and being treated with antibiotics were included in our study. The results were analyzed using descriptive statistics.Results: Out of 110 patients, female (58) and male (52) are enrolled in the study from inpatient paediatrics department, majority of patients belonged to age group of 0-5 years (74%), respiratory tract infections 29 (35%) , gastrointestinal infections 26 (22%) and central nervous system in 9 (11%). Out of 227 antimicrobial agent, about 83.48% were cephalosporins, followed by ciprofloxicin (33.94%), amoxicillin (32.11%), and amikacin (6.42%).Conclusions: Cephalosporins (ceftriaxone) were most commonly used antibiotic, which covers gram positive, gram negative and anaerobic organism.

Pattern of antibiotic prescriptions for outpatients with acute respiratory tract infections in Japan, 2013–15: a retrospective observational study

2018 ◽  
Vol 36 (4) ◽  
pp. 402-409 ◽  
Author(s):  
Yusuke Teratani ◽  
Hideharu Hagiya ◽  
Toshihiro Koyama ◽  
Mayu Adachi ◽  
Ayako Ohshima ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Oral Antibiotic ◽  
Third Generation ◽  
Acute Respiratory Tract Infections ◽  
Inappropriate Use ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Tract Infections ◽  
Third Generation Cephalosporins

Abstract Background In this age of antimicrobial resistance, unnecessary use of antibiotics to treat non-bacterial acute respiratory tract infections (ARTIs) and inappropriate use of antibiotics in treating bacterial ARTIs are public health concerns. Purpose Our aim is to identify the pattern of oral antibiotic prescriptions for outpatients with ARTIs in Japan. Methods We analysed health insurance claims data of patients (aged ≤74 years) from 2013 to 2015, to determine the pattern of antibiotic prescriptions for outpatient ARTIs and calculated the proportion of each antibiotic. Results Data on 4.6 million antibiotic prescriptions among 1559394 outpatients with ARTIs were analysed. The most commonly prescribed classes of antibiotics included cephalosporins (41.9%), macrolides (32.8%) and fluoroquinolones (14.7%). The proportion of first-, second- and third-generation cephalosporins was 1.0%, 1.7% and 97.3%, respectively. Fluoroquinolones accounted for a quarter of the prescriptions for ARTIs in patients aged >20 years. In contrast, penicillins accounted for just 8.0% of the total number of antibiotic prescriptions for ARTIs. Conclusions According to clinical guidelines, penicillins are first-line antibiotics against ARTIs. However, third-generation cephalosporins, macrolides and fluoroquinolones are more frequently prescribed in Japan. Although we could not assess the extent to which appropriate antibiotics are selected, our results support the necessity of improving antibiotic choices in the treatment of ARTIs.

scholarly journals A PRESCRIPTION PATTERN STUDY OF RESPIRATORY TRACT INFECTIONS IN PAEDIATRIC INDOOR PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL - A PROSPECTIVE OBSERVATIONAL STUDY

2018 ◽  
Vol 11 (7) ◽  
pp. 251 ◽  
Author(s):  
Vandana Badar ◽  
Vidisha Parulekar ◽  
Priti Garate
Keyword(s):  
Observational Study ◽  
Respiratory Tract ◽  
Teaching Hospital ◽  
Respiratory Tract Infections ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Acute Bronchiolitis ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Tract Infections

Objectives: The objectives of the study were as follows: (1) To study the prescription patterns in Respiratory tract infections (RTI) in indoor patients in pediatric wards. (2) To check the rationality of treatment according to Modified Kunin’s rationality criteria. (3)To analyze the data of RTI by Anatomical Therapeutic Chemical classification.Methods: It was a non-interventional, prospective, observational study which was conducted in indoor pediatric patients in a tertiary care teaching hospital in India. Data were analyzed and evaluated according to the WHO rational use of drugs guidelines.Study sample: The study sample was 174.Study duration: The study duration was August 15, 2016–September 15, 2016.Results: Males (63.79%) were more as compared to females (36.20%), and the highest number of cases was seen in infants (62.06%). Acute bronchiolitis (54.02%) was highest in the incidence followed by Wheeze Associated Lower Respiratory Tract Infection (WALRI) (30.45%). The average duration of patient stay in hospital was 4.71 days whereas 93.33% were polytherapy and mostly prescribed antibiotic was amoxicillin-clavulanic acid in acute bronchiolitis and WALRI. Salbutamol (40.84%) and Ipratropium Bromide (39.43%) were the commonly prescribed respiratory medicines. Oral route (42.27%) was the most common route of administration. 56.11% drugs were prescribed by generic name.Conclusion: Standard treatment guidelines for the treatment of RTI need to be urgently developed and strictly implemented.

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