scholarly journals Effect of Monthly Evaluations on Irrational Rates of Antimicrobial Drug Prescription in Outpatient and Emergency Departments

2021 ◽  
Author(s):  
Qiong Yang ◽  
Fangfang Yuan ◽  
Li Li ◽  
Jianfeng Jin ◽  
Junhong He
Keyword(s):  
Emergency Departments ◽  
Drug Prescription ◽  
Antibiotic Use ◽  
Management Tool ◽  
Prescription Rate ◽  
Evaluation Team ◽  
Utilisation Rate ◽  
Expert Team ◽  
Rational Use Of Antibiotics ◽  
Clinical Drug

Abstract Reduction of the excessive rate of antibiotic prescription is needed to curb antibiotic resistance. This retrospective study was conducted to verify whether monthly evaluations of antibiotic prescriptions could improve clinical antibiotic use in outpatient and emergency departments. Every month, from July 2016 to June 2019, 25% of the antibacterial prescriptions from the outpatient and emergency departments in our hospital were randomly selected. The hospital formed an evaluation team that conducted preliminary evaluations of these prescriptions and an expert team that re-evaluated any problematic prescriptions. We analysed the irrational prescription rate, proportion of antibiotic use, and consistency between the evaluation and expert teams. At the end of the evaluation period, the utilisation rate of single antibiotics in the outpatient and emergency departments increased, the irrational prescription rate decreased, and the proportion of sold antibiotics gradually decreased. In addition, the consistency of prescription evaluation results between the evaluation and expert groups increased over time. In conclusion, monthly evaluation of antibiotic prescriptions is an effective management tool for the rational use of antibiotics in clinical practice and plays an important role in safe clinical drug use.

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

scholarly journals Broad Spectrum project: factors determining the quality of antibiotic use in primary care: an observational study protocol from Italy

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038843
Author(s):  
Peter Konstantin Kurotschka ◽  
Alice Serafini ◽  
Marco Massari ◽  
Roberto Da Cas ◽  
Adolfo Figueiras ◽  
...  
Keyword(s):  
Drug Prescription ◽  
National Health System ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Prescription Data ◽  
Italian Region ◽  
Related Factors ◽  
Knowledge And Attitudes ◽  
The Impact

IntroductionThe overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia.Methods and analysisKnowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician.Ethics and disseminationThe project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community.

scholarly journals An Audit of Rational Use of Antibiotics in a Tertiary Hospital

2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Number Of Patients ◽  
Rational Use Of Antibiotics

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67

scholarly journals Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study

2014 ◽  
Vol 100 (5) ◽  
pp. 454-459 ◽  
Author(s):  
Indah K Murni ◽  
Trevor Duke ◽  
Sharon Kinney ◽  
Andrew J Daley ◽  
Yati Soenarto
Keyword(s):  
Developing Countries ◽  
Hand Hygiene ◽  
Infection Control ◽  
Antibiotic Stewardship ◽  
Hand Hygiene Compliance ◽  
Antibiotic Use ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Rational Use Of Antibiotics ◽  
Hospital Acquired

BackgroundPrevention of hospital-acquired infections (HAI) is central to providing safe and high quality healthcare. Transmission of infection between patients by health workers, and the irrational use of antibiotics have been identified as preventable aetiological factors for HAIs. Few studies have addressed this in developing countries.AimsTo implement a multifaceted infection control and antibiotic stewardship programme and evaluate its effectiveness on HAIs and antibiotic use.MethodsA before-and-after study was conducted over 27 months in a teaching hospital in Indonesia. All children admitted to the paediatric intensive care unit and paediatric wards were observed daily. Assessment of HAIs was made based on the criteria from the Centers for Disease Control and Prevention. The multifaceted intervention consisted of a hand hygiene campaign, antibiotic stewardship (using the WHO Pocket Book of Hospital Care for Children guidelines as standards of antibiotic prescribing for community-acquired infections), and other elementary infection control practices. Data were collected using an identical method in the preintervention and postintervention periods.ResultsWe observed a major reduction in HAIs, from 22.6% (277/1227 patients) in the preintervention period to 8.6% (123/1419 patients) in the postintervention period (relative risk (RR) (95% CI) 0.38 (0.31 to 0.46)). Inappropriate antibiotic use declined from 43% (336 of 780 patients who were prescribed antibiotics) to 20.6% (182 of 882 patients) (RR 0.46 (0.40 to 0.55)). Hand hygiene compliance increased from 18.9% (319/1690) to 62.9% (1125/1789) (RR 3.33 (2.99 to 3.70)). In-hospital mortality decreased from 10.4% (127/1227) to 8% (114/1419) (RR 0.78 (0.61 to 0.97)).ConclusionsMultifaceted infection control interventions are effective in reducing HAI rates, improving the rational use of antibiotics, increasing hand hygiene compliance, and may reduce mortality in hospitalised children in developing countries.

scholarly journals Study on knowledge, attitude and practices with respect to antibiotic use among medical students

2019 ◽  
Vol 8 (7) ◽  
pp. 1628
Author(s):  
Bhavika D. ◽  
A. Naga Teja Pavani ◽  
G. Meghavani ◽  
Aditya Jillella ◽  
Sameer Uz Zaman
Keyword(s):  
Antibiotic Resistance ◽  
Medical Students ◽  
Antibiotic Use ◽  
Educational Strategies ◽  
Key Factors ◽  
Cross Sectional ◽  
Response Options ◽  
Rational Use ◽  
Global Problem ◽  
Rational Use Of Antibiotics

Background: Antibiotic resistance has emerged as a serious global problem. Irrational prescribing of antibiotics is one of the key factors responsible for the development of antibiotic resistance. As today’s medical students will be the future prescribers their awareness regarding antibiotic resistance and rational prescribing of antibiotics is very much important. The main objective of the study was to evaluate the knowledge, attitude and practices of the medical students towards antibiotic use.Methods: A cross-sectional questionnaire-based study was conducted involving the medical students from all the semesters. A predesigned questionnaire was used to evaluate the knowledge, attitude and practices of the respondents. The response options were ‘yes’ or ‘no’ for some questions, and a 5 point Likert scale used to assess some questions. The data was analyzed using MS office Excel.Results: A total of 457 fully completed questionnaires from the respondents were evaluated. Majority of the respondents (70%) were females, and 91% of the respondents were aware of antibiotic resistance as a global problem. On analysis of score of questions assessing knowledge, 91% of respondents had attained a score in the range of 5-7. Majority (83%) of the respondents used antibiotics only on doctor’s prescription and 74% of the respondents had completed the prescribed course.Conclusions: The present study gives an insight on the knowledge, attitude and practices of medical students on antibiotic use, and can be used as a tool to plan educational strategies to improve the knowledge of the students regarding rational use of antibiotics.

scholarly journals Population knowledge and awareness of antibiotic use and antimicrobial resistance: results from national household survey 2019 and changes from 2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Viroj Tangcharoensathien ◽  
Sunicha Chanvatik ◽  
Hathairat Kosiyaporn ◽  
Supapat Kirivan ◽  
Wanwisa Kaewkhankhaeng ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Professionals ◽  
Household Survey ◽  
Antibiotic Use ◽  
Specific Information ◽  
Thai Population ◽  
National Strategic Plan ◽  
National Household Survey ◽  
The Government ◽  
Rational Use Of Antibiotics

Abstract Background Lack of knowledge and awareness on antimicrobial resistance (AMR) can result in irrational use of antibiotics, which is one of the major drivers of AMR. One goal of the Thailand National Strategic Plan on AMR (2017-2021) is a 20% increase in public knowledge and awareness of antibiotic use and AMR by 2021. This study assesses antibiotic use, level of knowledge and awareness of antibiotic use and AMR and the factors associated with their knowledge and awareness in the Thai population in 2019. It compares findings with a similar national survey in 2017. Methods An AMR module was integrated into the Health and Welfare Survey, a biennial national household survey conducted by the National Statistical Office since 2017. The 2019 survey took place in March, through face-to-face interviews with 27,900 Thai adults aged 15 years or above who participated in the survey and compares 2019 findings with those from 2017. Results One month prior to the survey, 6.3% of population reported use of antibiotics (reduced from 7.9% to 2017), of which 98.1% received antibiotics through healthcare professionals and almost half (43.2%) for flu symptoms. During the last 12 months, 21.5% of Thai adults received information on the appropriate use of antibiotics and AMR (increased from 17.8% to 2017); mostly through health professionals (82.7%). On knowledge, 24.3% of adults gave correct answers to more than three out of six statements (three true and three false statements) (increased from 23.7% to 2017). The overall mean score of awareness of appropriate antibiotic use and AMR is 3.3 out of total score of 5. Conclusions Although progress was made on knowledge and awareness between 2017 and 2019, certain practices, such as use of antibiotics for flu symptoms and receiving information about antibiotic use and AMR, are inappropriate and inadequate. These findings require significant action, notably strengthening health professionals’ ability to prescribe and dispense antibiotics appropriately and effective communication with patients. The government should promote specific information on rational use of antibiotics and AMR to specific target groups.

scholarly journals Pengaruh Pemberian Edukasi Terhadap Pasien Rawat Jalan Tentang Penggunaan Antibiotik di RSUD Kanjuruhan Kabupaten Malang

2020 ◽  
Vol 6 (1) ◽  
pp. 57-62
Author(s):  
Wirda Anggraini ◽  
◽  
Melisa Rezki Puspitasari ◽  
Ria Ramadhani Dwi Atmaja ◽  
Hajar Sugihantoro ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Antibiotic Use ◽  
Pharmacological Therapy ◽  
P Value ◽  
Inappropriate Use ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
Level Of Knowledge ◽  
Rational Use Of Antibiotics

Antibiotics are drugs that work to kill and or inhibit bacterial growth. Antibiotics are a class of prescriptions drugs that are widely used in the management of pharmacological therapy. Antibiotic knowledge must be used rationally and requires knowledge for the patient. Low levels of knowledge about the use of antibiotics can lead to inappropriate use of antibiotics, so there is a risk of causing side effects of antibiotics. Providing education is one way that can be used to increase knowledge about rational use of antibiotics. The aim of this research was to determine the effect of education on the use of antibiotics on outpatients at Kanjuruhan Hospital Malang Regency. This type of research was an Quasi-experimental by using one group pre-test post-test and prospective with sampling using accidental sampling technique data collection of 62 respondents. The result of the research showed that in pre test 44% respondents were having lack antibiotic-use knowledge, 35% respondents were having sufficient antibiotic-use knowledge, and 21% respondents were having good antibiotic-use knowledge. In post-test, 3% respondents belong to low-category, 15% respondents belong to medium-category, and 82% respondents belong to high-category. The T-test showed differences in scores between before and after being given education with a significance value of 0.00 (p value <0.05). The conclusion of this research is that there is an effect of providing education on the level of knowledge of outpatients in Kanjuruhan Hospital Malang Regency.

scholarly journals Knowledge, attitude and practice towards antibiotic use and resistance among the veterinarians in Bangladesh

2021 ◽  
Author(s):  
Md Samun Sarker ◽  
Iftekhar Ahmed ◽  
Shariful Islam ◽  
Ruhena Begum ◽  
Ayesha Ahmed ◽  
...  
Keyword(s):  
Viral Infections ◽  
Antibiotic Use ◽  
Health Concern ◽  
Feed Water ◽  
Growth Promoter ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Rational Use Of Antibiotics ◽  
First Time ◽  
Knowledge Attitude And Practice

Background The emergence of antimicrobial resistance (AMR) is growing public health concern around the world. When a number of studies have emphasized the Knowledge, Attitude and Practice (KAP) regarding antibiotic use and resistance in humans, little attention has been paid to the veterinary sector. The aim of this study was to understand the KAP towards antibiotic use and resistance among the veterinarians in Bangladesh. Methods A cross-sectional online based questionnaire survey was conducted from August to September 2020 among the registered veterinary practitioners. A self-administered Google form questionnaire consists of 46 questions on knowledge, attitude and practice regarding antibiotic use and their resistance. Results A total of 208 registered veterinarians participated in this study. 85.1% of the participants were male and 55% of the participants had a Masters degree. Around 50% of the veterinarians were poultry practitioners. All respondents were familiar with antimicrobials. 91.35% of the participants knew that antibiotics can not cure viral infections while 97.6% believed that frequent antibiotic prescription rendered them less effective. Participants claimed that only they are eligible to prescribe drugs for the treatment of animals. Of the total participants, 87.02% believed that a local antimicrobial guideline would be more effective than an international one while around 80% disagreed with adding antibiotics with feed/water as a growth promoter in livestock. However, gaps in practices were highlighted, suggesting training deficiencies. Conclusion The study for the first time conducted in Bangladesh dictates the future interventions like courses, workshops, and seminars on antibiotic usage and resistance are needed to ameliorate the awareness and change the behavior of veterinarians with regards to the rational use of antibiotics while also considering individual motivations and justifications for using antibiotics.

scholarly journals Antibiotic use in Moshi Urban: A cross-sectional Study of Knowledge and Practices among Caretakers of Children in Kilimanjaro Tanzania

2021 ◽  
Vol 4 (3) ◽  
pp. 347-356
Author(s):  
Benedicto J Petro ◽  
Sixbert Isdory Mkumbaye ◽  
Rukia Rajab Bakar ◽  
Nassra Is-hak Yussuf ◽  
Pius G. Horumpende ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Sectional Study ◽  
Self Medication ◽  
Cross Sectional ◽  
Media Campaigns ◽  
Antibiotics Use ◽  
Sick Children ◽  
Rational Use Of Antibiotics

IntroductionAntibiotics are commonly accessed and used for the management of illness in children without a prescription. We investigated the caretaker’s knowledge and practices on antibiotics and antibiotics use to their children.MethodThis was the hospital-based cross-sectional study conducted from April to July 2017 in three facilities located in Moshi Municipality. A convenience sampling was employed to select for caretakers with their sick children at KCMC, Mawenzi hospital, and Longuo dispensary. Face-to-face interviews were conducted with 224 caretakers who had visited health facilities with their children seeking health care.ResultsThe majority (87.9%, 197/224) of all interviewed caretakers had good knowledge of the use of antibiotics. Irrespective of knowing that it is not safe to self-medicate a child with any antibiotics (95.1%, 213/224), most (61.6%, 138/224) caretakers practiced self-medication with the medicines. Having two children (aOR = 7.75, 95% CI: 1.89-31.67) and having three children (aOR=7.23, 95%CI: 1.08-48.51) were significantly associated with good knowledge of antibiotics.ConclusionThis study has revealed that caretakers in Moshi had a good knowledge of antibiotic use. However, despite such good knowledge, malpractices were observed. We call upon the use of media campaigns to advocate for the importance of the rational use of antibiotics and its effect on human health and the risk of antimicrobial resistance development.Rwanda J Med Health Sci 2021;4(3):347-356

Evaluation of ambulatory antibiotic use in Hungary using drug-specific quality indicators

2013 ◽  
Vol 154 (24) ◽  
pp. 947-956 ◽  
Author(s):  
Mária Matuz ◽  
Ria Benkő ◽  
Edit Hajdú ◽  
Réka Viola ◽  
Gyöngyvér Soós
Keyword(s):  
Quality Indicators ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Consumption Patterns ◽  
Defined Daily Dose ◽  
Beta Lactams ◽  
Daily Dose ◽  
Constant Quantity ◽  
Rational Use Of Antibiotics

Introduction: Rational use of antibiotics is an important tool in combating antibiotic resistance. Aim: The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. Method: Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. Results: Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. Conclusion: In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries. Orv. Hetil., 2013, 154, 947–956.

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