scholarly journals Cost-analysis of antibiotic prescription incases of upper respiratory infection (URIs) and acute diarrhea (AD): a cross sectional studyin a district hospital

2019 ◽  
Vol 46 (1) ◽  
pp. 33-38
Author(s):  
Surin Buakaew ◽  
Thanapoom Kiewchaum ◽  
Vayroj Laophokhin ◽  
Nantawarn Kitikannakorn
Keyword(s):  
Cost Analysis ◽  
Respiratory Infection ◽  
Acute Diarrhea ◽  
District Hospital ◽  
Antibiotic Prescription ◽  
Cross Sectional ◽  
Upper Respiratory Infection ◽  
Upper Respiratory

scholarly journals A simulated client exploration of nonprescription availability of antibiotics at drugstores for childhood acute diarrhea and upper respiratory infection in Lahore, Pakistan

2020 ◽  
Author(s):  
Usman Rashid Malik ◽  
Jie Chang ◽  
Furqan Hashmi ◽  
Naveel Atif ◽  
Hareem Basir ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Acute Diarrhea ◽  
Viral Infections ◽  
Cross Sectional Study ◽  
Easy Access ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Upper Respiratory Infection ◽  
Upper Respiratory

Abstract Background The excessive consumption of antibiotics is a major contributor to antimicrobial resistance, especially in children. Children are often being advised antibiotics for viral infections. In developing countries, the drugstores are a prime source of easy access to nonprescription antibiotics. Also, in Pakistan, their irrational use is an “everyday routine”. The study, therefore, aimed to evaluate the dispensing of nonprescription antibiotics for children at drugstores of Lahore, Pakistan.Methods Using the pediatric acute diarrhea and acute upper respiratory infection as disease scenarios, a simulated client, cross-sectional study was conducted in Lahore, Pakistan to explore the antibiotics’ ease of availability at both categories of drugstores (pharmacies and medical stores) from November 1st, 2019 to January 31st, 2020. Chi-square (x2) test was used to compare the differences in practices of different categorical variables. Multivariable logistic regression was applied to analyze the association of various factors with antibiotics dispensing.Results Antibiotics were dispensed without prescription in 456 (59%) of 773 simulated visits out of which 425 (93.2%) were dispensed on the advice of the drugstore staff. The qualified pharmacist was available in only 164 (21.2%) cases. Of 386 visits for acute diarrhea and 387 for acute upper respiratory infection, nonprescription antibiotic dispensing occurred in 259 (67.1%) and 197 (50.9%) visits respectively. The considerable differences (p-value < 0.05) were observed between the practices of the towns, disease scenario presented, categories of drugstores, and pharmacist-supervised drugstores. Conclusions The inappropriate dispensing practices were prevalent to a large extent at the drugstores and antibiotics were effortlessly obtainable without prescriptions. The quality of the services provided, especially by the non-pharmacist staff, was also not satisfactory. Therefore, the Drug Regulating Authority of Pakistan must enforce strict implementation of drug laws at the drugstores without delays especially in major cities to help curb the felonious use of antibiotics.

scholarly journals 2201. Cost of Antimicrobial Use Against Upper Respiratory Infection in Japan

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S750-S750
Author(s):  
Shinya Tsuzuki ◽  
Yuki Kimura ◽  
Masahiro Ishikane ◽  
Yoshiki Kusama ◽  
Norio Ohmagari
Keyword(s):  
Respiratory Infection ◽  
Annual Cost ◽  
Social Insurance ◽  
Antibiotic Prescription ◽  
National Level ◽  
Population Data ◽  
Additional Cost ◽  
Total Annual Cost ◽  
Upper Respiratory Infection ◽  
Upper Respiratory

Abstract Background Antibiotics are often inappropriately prescribed for treating upper respiratory infection (URI) patients in ambulatory care settings. In Japan, a previous study estimated physicians prescribed antibiotics in about 30% of URI cases. However, trends of prescription behavior and additional costs of inappropriate antibiotic use in URI cases are still not clear in Japan. The present study’s main objective was to clarify the amount of additional cost owing to inappropriate antibiotic prescription for URI, and the recent trend. Methods We conducted a retrospective observational survey using longitudinal claims data spanning 2013–2016, obtained from the Japan Medical Data Center Co., Ltd. (JMDC) Claims Database, which contains anonymous claim data on 5.1 million (for 2013–2016) corporate employees covered by the employees’ health insurance plan (Social insurance), and their family members <65 years old. Six physicians specialized in infectious disease assessed the appropriateness of antibiotic prescription based on the ICD-10 code in the database. The total additional cost of antibiotic prescription for URI at the national level was estimated by weighting corresponds to the age-structured population data, from the healthcare payer perspective. Costs of treatment for adverse events and of antimicrobial resistance caused by inappropriate antibiotic prescription were not taken into consideration. Results The total annual cost of antibiotic prescription for URI was estimated at US$423.6 (95% confidence interval: 416.8–430.5) million in 2013, $340.9 (335.7–346.2) million in 2014, $349.9 (344.5–355.3) million in 2015, and $297.1 (292.4–301.9) million in 2016. Conclusion Although a decreasing trend was observed, the annual cost of antibiotic prescription for URI potentially imposes a substantial economic burden in Japan. Disclosures All authors: No reported disclosures.

scholarly journals Cost of inappropriate antimicrobial use for upper respiratory infection in Japan

2020 ◽  
Author(s):  
Shinya Tsuzuki ◽  
Yuki Kimura ◽  
Masahiro Ishikane ◽  
Yoshiki Kusama ◽  
Norio Ohamagari
Keyword(s):  
Ambulatory Care ◽  
Respiratory Infection ◽  
Broad Spectrum ◽  
Economic Burden ◽  
Antibiotic Prescription ◽  
Additional Cost ◽  
Oral Antibiotics ◽  
Upper Respiratory Infection ◽  
Claims Database ◽  
Upper Respiratory

Abstract Background : Antibiotics are often prescribed inappropriately to patients with upper respiratory infection (URI) in ambulatory care settings; however, the economic burden of such prescription has not been quantitatively assessed. Here, we aimed to evaluate the additional cost of antimicrobial prescription for URI at the population level in Japan. Methods : We conducted a retrospective observational survey using longitudinal claims data between 2013 and 2016 obtained from JMDC Claims Database, which contains data from 5·1 million corporate employees and family members under the age of 65 years. Appropriateness of antibiotic prescription was assessed by a panel of six infectious disease physicians according to ICD-10 code in JMDC Claims Database. Total additional cost of antibiotic prescription for URI at the national level was estimated by weighting of age-structured population data. Results : The annual additional cost of inappropriate antibiotic prescription for URI was estimated at 423·6 (95% CI: 416·8–430·5) million USD in 2013, 340·9 (95% CI: 335·7–346·2) million USD in 2014, 349·9 (95% CI: 344·5–355·3) million USD in 2015, and 297·1 (95% CI: 292·4–301·9) million USD in 2016. Three classes of broad-spectrum oral antibiotics (third-generation cephalosporins, macrolides, and fluoroquinolones) accounted for >90% of the total additional cost. Conclusions : Although a decreasing trend was observed, annual additional costs of inappropriate antibiotic prescriptions for URI could be a substantial economic burden in Japan. Appropriately prescribing broad-spectrum oral antibiotics might be an important issue to reduce unnecessary medical costs in Japanese ambulatory care.

Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection?

1996 ◽  
Vol 85 (3) ◽  
pp. 475-480. ◽  
Author(s):  
Mark S. Schreiner ◽  
Irene O'Hara ◽  
Dorothea A. Markakis ◽  
George D. Politis
Keyword(s):  
Confidence Interval ◽  
Respiratory Infection ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Upper Respiratory Infection ◽  
Airway Surgery ◽  
Increased Risk ◽  
Upper Respiratory

Background Laryngospasm is the most frequently reported respiratory complication associated with upper respiratory infection and general anesthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods A case-control study was performed to examine whether children with laryngospasm were more likely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who were admitted through the day surgery unit were asked if their child had an active or recent (within 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait and Knight's definition of an upper respiratory infection. Control subjects were randomly selected from patients whose surgery had occurred within 1 day of the laryngospasm event. Results Patients who developed laryngospasm (N = 123) were 2.05 times (95% confidence interval 1.21-3.45) more likely to have an active upper respiratory infection as defined by their parents than the 492 patients in the control group (P &lt; or = 0.01). The development of laryngospasm was not related to Tait and Knight's definition for an upper respiratory infection or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence interval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.08, 95% confidence interval 1.21-3.59), and to have their anesthesia supervised by a less experienced anesthesiologist (odds ratio = 1.69, 95% confidence interval 1.04-2.7) than children in the control group. Conclusion Laryngospasm was more likely to occur in children with an active upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the risk factors and the magnitude of the likely risk should help clinicians make the decision as to whether to anesthetize children with upper respiratory infection.

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