scholarly journals Evaluation of the Appropriate Use of Ceftriaxone in Internal Medicine Wards of Wad Medani Teaching Hospital in Sudan

2020 ◽  
Vol 7 (03) ◽  
pp. 4757-4765
Author(s):  
Mohammed I. Malik ◽  
Mohmmed Albadawy M. Alagab ◽  
Maha Mirghani Maatoug ◽  
Fawkia E. Zahran ◽  
Abelhameed H. Elmubarak ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Teaching Hospital ◽  
Bacterial Resistance ◽  
Treatment Guidelines ◽  
Sensitivity Test ◽  
Appropriate Use ◽  
Dose Frequency ◽  
Cross Sectional ◽  
Internal Medicine Wards ◽  
Culture And Sensitivity

Background: Antibiotics are one of the commonly prescribed drugs over the world. Overprescribing of antibiotics may result in serious bacterial resistance. The main cause of inappropriate prescription of antibiotics is the absence of guidelines and protocols for its use. The aim of this study was to evaluate the appropriate use of ceftriaxone (broad-spectrum third generation cephalosporin antibiotic) in internal medicine wards of Wad Medani teaching hospital in Sudan, as well as comparing its use with reference to the standard of Sudan treatment guidelines and reliable references like British National Formula (BNF) and Sanford guide. Methods: Prospective cross –sectional study conducted in the internal medicine department at Wad Medani Teaching hospital by reviewing the files of all in-patients admitted to medical wards, who received ceftriaxone between November and December, 2018 and the appropriateness use of ceftriaxone was evaluated depending on six criteria: indication, dose, frequency, duration of treatment, culture and sensitivity test and drug –drug interaction Results: A total of 280 admitted patient’s treatment chart containing ceftriaxone injection were analyzed. Ceftriaxone was indicated empirically in 91.1% mostly for respiratory tract infection (35%). Ceftriaxone appropriate dose was given in 59% of patients, inappropriate frequency in 68.9% and incorrect duration in 51.1%. Co-administered drugs with major interaction in 3.6% of patients. Conclusions: This study revealed high inappropriate use of ceftriaxone where it was given without implementing culture and sensitivity test in the majority of patients. This may result in treatment failure so educational programs is recommended to address the irrational use of antibiotic.

scholarly journals Analysis of Quality of Antibiotic Usage on Patient with Internal and Surgical Service

2021 ◽  
Vol 57 (1) ◽  
pp. 1
Author(s):  
Nurul Ma'rifah ◽  
Didik Hasmono ◽  
Usman Hadi ◽  
Kuntaman Kuntaman
Keyword(s):  
Internal Medicine ◽  
Analytical Study ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Developed Countries ◽  
Surgical Patients ◽  
Appropriate Use ◽  
Cross Sectional ◽  
Inappropriate Use

It is well-known that hospitals are health facility with the widely use of antibiotics. It is about 13-37% from the total hospitalized patients in developed countries use antibiotic, even in developing countries can reach 30-80%. There is identified correlation between antibiotic use and the development of bacterial resistance. Even though the resistance cannot be eliminated, but its development can be suppressed  by the increasing of prudent use of antibiotics. The aim of this study was to determine the quality of antibiotic use on internal medicine and surgical patients in Aisiyah Hospital Bojonegoro. The study was a prospective cross sectional observational analytical study of among patients of internal and surgical who received antibiotic therapy in the period of August - September 2017. The total 50 samples were collected in this study which consists of 33 internal medicine  and 17 surgical patients. From 50 samples, there were 16 types of antibiotics with the total use of 81 of antibiotic use. As the result, in internal medicine patients there were 22 (40%) of appropriate use of antibiotics, 4 (7.27%) of inappropriate use and 29 (52.73%) use of antibiotics without indication. In surgical patients, there were 12 (46.15%) of appropriate use of antibiotics, 2 (7.69%) of inappropriate use and 12 (46.15%) use of antibiotics without indication. This study showed that more than 50% of antibiotic use were inappropriate, and mainly antibiotic with no indication, among patients hospitalized in Aisyiyah Hospital Bojonegoro.

scholarly journals Comparative study of the prevalence of sepsis in patients admitted to dermatology and internal medicine wards

2013 ◽  
Vol 88 (5) ◽  
pp. 739-747
Author(s):  
Luiz Mauricio Costa Almeida ◽  
Michelle dos Santos Diniz ◽  
Lorena dos Santos Diniz ◽  
Jackson Machado-Pinto ◽  
Francisco Chagas Lima Silva
Keyword(s):  
Internal Medicine ◽  
Comparative Study ◽  
Medical Records ◽  
Skin Barrier ◽  
Epidemiological Studies ◽  
Internal Medicine Ward ◽  
Cross Sectional ◽  
Systemic Corticosteroids ◽  
Internal Medicine Wards ◽  
Belo Horizonte

BACKGROUND: Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES: To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS: It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS: We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION: It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.

Effectiveness of treatment of tonsillopharyngitis: comparative study

2002 ◽  
Vol 116 (11) ◽  
pp. 917-919 ◽  
Author(s):  
Khader J. Abdul-Baqi ◽  
Farouk M. N. Shakhatreh
Keyword(s):  
Bacterial Resistance ◽  
Viral Infections ◽  
Antibiotic Use ◽  
Sensitivity Test ◽  
Group Iii ◽  
Group I ◽  
Culture And Sensitivity ◽  
Group Ii ◽  
The Difference ◽  
Selection Of

This study was performed to find out the effectiveness of three different treatments of patients having acute tonsillopharyngitis. Three groups of patients were selected (50 patients in each group). Group I received one antibiotic according to the result of culture and sensitivity test, while groups II and III received two antibiotics or one antibiotic respectively without a culture and sensitivity test. Diagnosis was based on the acutely subjective symptoms of sore throat and positive clinical examination findings. The effectiveness of treatment in group I (96 per cent) was statistically significant (p<0.05) and higher than group II (82 per cent) and group III (74 per cent), while the difference between group II and III was not statistically significant (p>0.05).Our findings demonstrate that a culture and sensitivity test of the throat swab is necessary before treating acute tonsillopharyngitis. It was suggested that there should be appropriate selection of antibiotics to preserve normal flora, avoidance antibiotics for viral infections, patient compliance with prescription and educational programmes directed at patients and physicians. All of these measures would assist in reducing the volume of antibiotic use, bacterial resistance and the overall cost of treatment of tonsillopharyngitis.

scholarly journals Detection and Management of Common Medication Errors inInternal Medicine Wards: Impact on Medication Costs and Patient Care

2019 ◽  
Vol 9 (1) ◽  
pp. 174-179 ◽  
Author(s):  
Kamal Boostani ◽  
Hamid Noshad ◽  
Farahnoosh Farnood ◽  
Haleh Rezaee ◽  
Soheil Teimouri ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Pharmaceutical Care ◽  
Medication Errors ◽  
Clinical Pharmacist ◽  
Health Care Team ◽  
Inappropriate Drug ◽  
Cross Sectional ◽  
Medication Therapy ◽  
Medication Costs ◽  
Internal Medicine Wards

Introduction: Medication errors (MEs) are a leading cause of morbidity and mortality, yet they have remained as confusing and underappreciated concept. The complex pharmacotherapy in hospitalized patients and sometimes serious clinical consequences of MEs necessitate continued report and surveillance of MEs as well as persistent pharmaceutical care for patients at medical wards. This study evaluated the frequency, types, clinical significance, and costs of MEs in internal medicine wards. Method: In this 8-month prospective and cross-sectional study, an attending clinical pharmacist, as an integral member of a health care team, visited the patients during each physician's ward round at the morning. All MEs including prescription, transcription, and administration errors were detected, recorded, and subsequently appropriate corrective interventions were proposed during these rounds. The changes in the medications' cost after implementing clinical pharmacist's interventions were compared to the calculated medications' cost, assuming that the MEs would not have been detected by clinical pharmacist and continued up to discharge time of the patients. Results: 89% of the patients experienced at least one ME during their hospitalization. A mean of 2.6 errors per patient or 0.2 errors per ordered medication occurred in this study. More than 70% of MEs happened at the prescription stage by treating physicians. The most prevalent prescription errors were inappropriate drug selection, unauthorized drugs and untreated indication. The highest MEs occurred on cardiovascular agents followed by antibiotics, and vitamins, minerals, and electrolytes. Total number of MEs showed a marked correlation with the total number of ordered medications and patients’ length of hospitalization. The net effect of clinical pharmacist’s contributions in medication therapy management was to decline medications’ costs by 33.9%. None of the MEs caused the patients harm. Conclusion: The role of clinical pharmacy services in detection, prevention and reducing the cost of MEs is of paramount importance to internal medicine wards. Key words: clinical pharmacist; medication errors; pharmaceutical care; internal medicine.

scholarly journals Prevalence of Nutritional Risk at Admission in Internal Medicine Wards in Portugal: The Multicentre Cross-Sectional ANUMEDI Study

2021 ◽  
Vol 34 (6) ◽  
pp. 420
Author(s):  
Ricardo Marinho ◽  
Ana Pessoa ◽  
Marta Lopes ◽  
João Rosinhas ◽  
João Pinho ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Nutritional Risk ◽  
Charlson Comorbidity Index Score ◽  
Cross Sectional ◽  
Risk Screening ◽  
Internal Medicine Wards ◽  
Nutritional Risk Screening 2002 ◽  
Nutritional Risk Screening

Introduction: Disease-related undernutrition is highly prevalent and requires timely intervention. However, identifying undernutrition often relies on physician judgment. As Internal Medicine wards are the backbone of the hospital setting, insight into the prevalence of nutritional risk in this population is essential. We aimed to determine the prevalence of nutritional risk in Internal Medicine wards, to identify its correlates, and to assess the agreement between the physicians’ impression of nutritional risk and evaluation by Nutritional Risk Screening 2002.Material and Methods: A cross-sectional multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Data on demographics, previous hospital admissions, primary diagnosis, and Charlson comorbidity index score were collected. Nutritional risk at admission was assessed using Nutritional Risk Screening 2002. Agreement between physicians’ impression of nutritional risk and Nutritional Risk Screening 2002 was tested by Cohen’s kappa.Results: The study included 729 participants (mean age 74 ± 14.6 years, 51% male). The main reason for admission was respiratory disease. Mean Charlson comorbidity index score was 5.8 ± 2.8. Prevalence of nutritional risk was 51%. Nutritional risk was associated with admission during the previous year (odds ratio = 1.65, 95% confidence interval: 1.22 - 2.24), solid tumour with metastasis (odds ratio = 4.73, 95% confidence interval: 2.06 - 10.87), any tumour without metastasis (odds ratio = 2.04, 95% confidence interval:1.24 - 3.34), kidney disease (odds ratio = 1.83, 95% confidence interval: 1.21 - 2.75), peptic ulcer (odds ratio = 2.17, 95% confidence interval: 1.10 - 4.25), heart failure (odds ratio = 1.51, 95% confidence interval: 1.11 - 2.04), dementia (odds ratio = 3.02, 95% confidence interval: 1.96 - 4.64), and cerebrovascular disease (odds ratio = 1.62, 95% confidence interval: 1.12 - 2.35). Agreement between physicians’ evaluation of nutritional status and Nutritional Risk Screening 2002 was weak (Cohen’s kappa = 0.415, p < 0.001).Discussion: Prevalence of nutritional risk in the Internal Medicine population is very high. Admission during the previous year and multiple comorbidities increase the odds of being at-risk. Subjective physician evaluation is not appropriate for nutritional screening.Conclusion: The high prevalence of at-risk patients and poor subjective physician evaluation suggest the need to implement mandatory nutritional screening.

scholarly journals Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients

2019 ◽  
Vol 8 (5) ◽  
pp. 1106
Author(s):  
Manoj H. Thummar ◽  
Tejas K. Patel ◽  
Varsha Y. Godbole ◽  
Manoj Kumar Saurabh
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Elderly Inpatients ◽  
Internal Medicine Wards ◽  
Inappropriate Medications

Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (≥65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.

Perceptions of slow codes by nurses working on internal medicine wards

2018 ◽  
Vol 26 (6) ◽  
pp. 1734-1743 ◽  
Author(s):  
Freda DeKeyser Ganz ◽  
Rotem Sharfi ◽  
Nehama Kaufman ◽  
Sharon Einav
Keyword(s):  
Internal Medicine ◽  
Standard Deviation ◽  
Personal Characteristics ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Ethical Implications ◽  
Cardio Pulmonary Resuscitation ◽  
Ethical Approval ◽  
Internal Medicine Wards ◽  
Patient Prognosis

Background: Cardio-pulmonary resuscitation is the default procedure during cardio-pulmonary arrest. If a patient does not want cardio-pulmonary resuscitation, then a do not attempt resuscitation order must be documented. Often, this order is not given; even if thought to be appropriate. This situation can lead to a slow code, defined as an ineffective resuscitation, where all resuscitation procedures are not performed or done slowly. Research objectives: To describe the perceptions of nurses working on internal medicine wards of slow codes, including the factors associated with its implementation. Research design: This was a cross-sectional, descriptive study. Participants completed a personal characteristics questionnaire and the Perceptions and Factors of Slow Codes questionnaire designed for this study. Participants and research context: The sample was a convenience sample of nurses working on internal medicine wards in two Israeli hospitals. Ethical considerations: The study received ethical approval from both institutions, where data were collected and stored according to institutional policy. Findings: Most reported that resuscitations were conducted according to protocol (n = 90, 76.2%). Some took their time calling the code (n = 22, 18.3%), or waited by the bedside and did not perform cardio-pulmonary resuscitation (n = 45, 37.5%). Factors most associated with slow codes were poor patient prognosis (mean = 3.52/5, standard deviation = 1.27) and a low chance of patient survival (mean = 3.37/5, standard deviation = 1.21). Two-thirds (n = 76, 66.8%) reported that slow codes were done on their unit and the majority (n = 80, 69%) perceived slow codes as ethical. Discussion: This study confirms that slow codes are part of medical care on internal medicine wards, where most nurses perceive them as an ethical alternative. These perceptions are in contrast to most legal and ethical opinions expressed in the literature. Conclusion: Nurses should be educated about the legal and ethical implications of slow codes, and qualitative and quantitative studies should be conducted that further investigate its implementation.

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