scholarly journals Community pharmacists’ management of self-limiting infections: a simulation study in Akwa Ibom State, South-South Nigeria

2021 ◽  
Vol 21 (2) ◽  
pp. 576-584
Author(s):  
Richard Mary Akpan ◽  
Emmanuel Imo Udoh ◽  
Samuel Emediong Akpan ◽  
Chioma Cynthia Ozuluoha
Keyword(s):  
Antibiotic Resistance ◽  
Common Cold ◽  
Patient Simulation ◽  
Acute Diarrhoea ◽  
Community Pharmacists ◽  
Simulated Patient ◽  
High Rate ◽  
Inappropriate Use ◽  
Inappropriate Antibiotics ◽  
Pharmacy Curriculum

Background: Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are dispensed only when necessary. Objective: To assess community pharmacists’ management of self-limiting infections. Methods: A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit. Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research Ethics Committee. Results: For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was ofered in 73% and 87% of the interactions, respectively. Conclusion: This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists. Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed. Keywords: Antibiotics; pharmacists; common cold; acute diarrhoea; community pharmacy; patient simulation.

scholarly journals The Practice of Counseling by Community Pharmacists in Bisha Health Directorate, Saudi Arabia – Simulated Patient Visit

2019 ◽  
Author(s):  
Hassan Mohammed Al Qarni ◽  
Tahani Alrahbeni ◽  
Ayidh M AlQarni ◽  
Abdullah Alqarni
Keyword(s):  
Saudi Arabia ◽  
Patient Simulation ◽  
Community Pharmacists ◽  
Significant Negative Correlation ◽  
Simulated Patient ◽  
World Health ◽  
Community Pharmacies ◽  
Patient Visit ◽  
Cross Sectional ◽  
Health Directorate

Abstract Background Many organizations have suggested a minimum standard of counseling for patients, which includes information about the name of the drug, description, indication, how to use it, the method of treatment, precautions, adverse reactions, and any contraindications. Correspondingly, the World Health Organization (WHO) has recommended spending at least 3 minutes with each patient to undertake counseling. The present study aimed to evaluate the practice of counseling by community pharmacists for both over-the-counter (OTC) and prescription-only medicines in Bisha Health Directorate, Saudi Arabia. Method This was a cross-sectional study designed to be a simulation patient visit to community pharmacies at Bisha area. The simulated patient visit were include 73 pharmacies. Two scenarios were used in the simulated patient visit. The first scenario was for a prescription-only medicine and the second scenario was for an OTC medicine. The time recorded for every visit to evaluate counsling period. Results A total of 105 visits were conducted to the community pharmacies as follows: scenario 1 = 73 and scenario 2 = 32. The average time for the simulation was 110 seconds in scenario 1 and 73.4 seconds in scenario 2. There was a statistically significant negative correlation between the period it took for the simulation scenario and the time of visit during the day (rho = −0.396, p = 0.001) in the patient simulation. Conclusion It that the service in community pharmacies is selling medicines and patient needs to be given a greaterin these community pharmacies.

scholarly journals Counselling Patterns of Community Pharmacies when Dispensing Antibiotics in Galle DS Division, Sri Lanka

2021 ◽  
pp. 41-49
Author(s):  
R. K. A. B. Nayanathara ◽  
B. G. V. A. N. S. Jayasinghe
Keyword(s):  
Sri Lanka ◽  
Community Pharmacists ◽  
Simulated Patient ◽  
Simulated Patients ◽  
Community Pharmacies ◽  
Specific Product ◽  
Health Authorities ◽  
History Of ◽  
Inappropriate Antibiotics ◽  
Significant Health

Antibiotic resistance has been identified as a significant health issueacross the world. Inappropriate antibiotics prescribing by physicians, dispensing antibiotics without prescription and counseling by pharmacists, and the misuse of antibiotics by patients make them chief parties responsible for this global problem. Community pharmacists have a major responsibility to counsel the patients before dispensing antibiotics. The objectives of this study was to investigate the counselling patterns of community pharmacies when dispensing antibiotics and to examine whether the community pharmacists demand a prescription when dispensing antibiotics in Galle, Sri Lanka. This was a simulated patient study involving community pharmacists/ pharmacy assistants who work in community pharmacies in the Galle DS division (Divisional Secretary Division), Sri Lanka. Case scenarios of specific product requests (Erythromycin tablets, Ciprofloxacin tablets, Amoxicillin syrup) were presented by a simulated patient, and data were recorded after purchasing each product. Most of the pharmacists/ pharmacy assistants (72%) didn’t demand a prescription for antibiotic dispensing. About 82% of the visited pharmacies had dispensed antibiotics without a prescription. Only 14% of community pharmacies in the area had taken medical and lifestyle history of simulated patients (investigators) before dispensing. Advice or counselling regarding antibiotics were given only by 24% of the community pharmacies. Counselling patterns of community pharmacies in the area were unsatisfactory. Major issues of dispensing antibiotics and, not demanding a prescription were common. These issues need to be addressed by health authorities and policymakers to safeguard patients.

scholarly journals Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 606
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Bustanul Arifin ◽  
Ikhwan Frasetyo ◽  
Setiasih ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
General Hospital ◽  
Sampling Technique ◽  
Knowledge Score ◽  
Antibiotic Use ◽  
Public Hospitals ◽  
Educational Video ◽  
Inappropriate Use ◽  
Quasi Experimental ◽  
The Difference

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

scholarly journals Appropriateness of antibiotics for medical prophylaxis: evaluation of data from the Italian PPS-2

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Cremona ◽  
J Garlasco ◽  
I Gintoli ◽  
A D'Ambrosio ◽  
F Quattrocolo ◽  
...  
Keyword(s):  
Empirical Therapy ◽  
Infectious Complications ◽  
High Rate ◽  
National Guidelines ◽  
Prevalence Survey ◽  
Inappropriate Use ◽  
Healthcare Associated ◽  
Evaluation Of Data ◽  
The Eu ◽  
Made In

Abstract Background Antibiotics (AB) are administered for medical prophylaxis (MP) to prevent infectious complications. The second national point prevalence survey (PPS) of healthcare-associated infections and AB use was conducted in Italy in 2016-2017. The survey found MP accounted for nearly 25% of all registered ABs, more than twice the EU/EEA proportion. The aim of this study was to evaluate how many ABs were administered for MP and how frequently general indications were followed. Methods Data from the PPS were used to evaluate the prevalence of indications for MP over the total number of ABs, the proportion - among these indications - of those justified by a motivation in the patients' charts, and the prevalence of ABs considered appropriate for MP. The evaluation was made in 12 hospitals out of 14 participating in the PPS in Piedmont, chosen on the basis of patient traceability. According to national guidelines, the indications for MP that were considered appropriate in this study were: Trimethoprim/sulfamethoxazole for P. carinii pneumonia, Rifaximin for diverticulitis, Penicillin for Streptococcal infections and for splenectomized patients, and Rifampin for TB infections. Results 1844 AB prescriptions were registered among 1334 traceable inpatients in Piedmont. The prevalence of indications for MP was 16.2% and 253 ABs (84.6%) were prescribed with a motivation. Only 3% of ABs registered as MP were appropriate for this indication: Bactrim 2%, Rifaximin 0.3%, Penicillin 0.2% and Rifampin 0.4%. Conclusions This study found an extremely high rate of inappropriate ABs for MP, that will be further investigated through qualitative analysis of medical records to evaluate whether a misunderstanding of the PPS protocol occurred and empirical therapy was confused with MP. Nevertheless, this study highlighted the need for interventions to improve prescribing appropriateness for MP. Key messages This study found that only 2.98% of ABs registered as MP among traceable patients in Piedmont were appropriate for this indication. 15.38% of prescriptions for MP were not justified by a motivation. Interventions to improve prescribing appropriateness for MP could lead to a considerable reduction in inappropriate use of ABs, which is crucial in a country facing hyperendemic levels of AMR.

scholarly journals Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 154
Author(s):  
Sisira Donsamak ◽  
Marjorie C. Weiss ◽  
Dai N. John
Keyword(s):  
Respiratory Infections ◽  
Acute Diarrhoea ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Community Pharmacies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Case Vignettes ◽  
A Chain

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.

Changes in the rate of prophylactic vena cava filter insertion at a university hospital

2015 ◽  
Vol 31 (6) ◽  
pp. 403-408
Author(s):  
Andrew Smith ◽  
Demetri Adrahtas ◽  
Doreen Elitharp ◽  
Antonios Gasparis ◽  
Nicos Labropoulos ◽  
...  
Keyword(s):  
Vena Cava ◽  
Vena Cava Filter ◽  
University Hospital ◽  
High Rate ◽  
Inappropriate Use ◽  
Surgical Critical Care ◽  
Change In Practice ◽  
Filter Insertion ◽  
Level I ◽  
Second Period

Objective We previously demonstrated a high rate of prophylactic vena cava filter (VCF) insertion at our institution. We have since attempted to restrict the use of VCF to indications supported by Level-I evidence. This study was designed to evaluate the success of our interventions. Methods All patients receiving VCF between 2007–2009 and 2012–2014 at a university hospital were reviewed. After assessing the use of VCF in the first period, a meeting was convened among the Departments of Radiology, Vascular Surgery and Trauma. Policy was implemented to avoid the inappropriate use of VCF. Data were prospectively collected in the second period to assess the effect of our intervention. Results There were 156 VCF placed from 2012 to 2014. VCF was absolutely indicated in 84% of cases, relatively indicated in 9% and prophylactic in 7%. These data contrast our previous experience from 2007 to 2009. In the earlier series, a total of 244 filters were placed, in which 54% of patients had an absolute indication, 14% relative, and 32% prophylactic. There was a significant decrease in filters placed for pure prophylaxis: whereas 76 prophylactic filters were placed between 2007 and 2009, only 11 were placed between 2012 and 2014 ( p < 0.0001). No significant differences existed for relatively indicated filters. The department of trauma and surgical critical care (TSCC) observed the most dramatic change in practice. TSCC placed 61 prophylactic VCF between 2007 and 2009 (57% of all filters placed by the department), and 4 prophylactic VCF from 2012 to 2014 (15% of filters placed by TSCC) ( p < 0.0001). Conclusion These findings demonstrate a significant change in the attitudes regarding prophylactic VCF insertion between the two periods of study. Further investigations must be performed to assess changes in clinical outcomes that may result from the altered practice at our university.

scholarly journals Bacteria and Their Antibiotic Resistance Profiles in Ambient Air in Accra, Ghana, February 2020: A Cross-Sectional Study

2021 ◽  
Vol 6 (3) ◽  
pp. 110
Author(s):  
Godfred Saviour Kudjo Azaglo ◽  
Mohammed Khogali ◽  
Katrina Hann ◽  
John Alexis Pwamang ◽  
Emmanuel Appoh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Pathogenic Bacteria ◽  
Ambient Air ◽  
Cross Sectional Study ◽  
Bacillus Species ◽  
Resistant Bacteria ◽  
Cross Sectional ◽  
Antibiotic Resistant ◽  
Bacterial Counts ◽  
Inappropriate Use

Inappropriate use of antibiotics has led to the presence of antibiotic-resistant bacteria in ambient air. There is no published information about the presence and resistance profiles of bacteria in ambient air in Ghana. We evaluated the presence and antibiotic resistance profiles of selected bacterial, environmental and meteorological characteristics and airborne bacterial counts in 12 active air quality monitoring sites (seven roadside, two industrial and three residential) in Accra in February 2020. Roadside sites had the highest median temperature, relative humidity, wind speed and PM10 concentrations, and median airborne bacterial counts in roadside sites (115,000 CFU/m3) were higher compared with industrial (35,150 CFU/m3) and residential sites (1210 CFU/m3). Bacillus species were isolated in all samples and none were antibiotic resistant. There were, however, Pseudomonas aeruginosa, Escherichia coli, Pseudomonas species, non-hemolytic Streptococci, Coliforms and Staphylococci species, of which six (50%) showed mono-resistance or multidrug resistance to four antibiotics (penicillin, ampicillin, ciprofloxacin and ceftriaxone). There was a positive correlation between PM10 concentrations and airborne bacterial counts (rs = 0.72), but no correlations were found between PM10 concentrations and the pathogenic bacteria nor their antibiotic resistance. We call for the expansion of surveillance of ambient air to other cities of Ghana to obtain nationally representative information.

scholarly journals Molecular Characteristics of Streptococcus pyogenes Isolated From Chinese Children With Different Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Dingle Yu ◽  
Yunmei Liang ◽  
Qinghua Lu ◽  
Qing Meng ◽  
Wenjian Wang ◽  
...  
Keyword(s):  
Gene Expression ◽  
Antibiotic Resistance ◽  
Streptococcus Pyogenes ◽  
Wide Spectrum ◽  
Expression Patterns ◽  
Virulence Gene ◽  
High Rate ◽  
Molecular Characteristics ◽  
Virulence Gene Expression ◽  
Obstructive Sleep

Streptococcus pyogenes is a bacterial pathogen that causes a wide spectrum of clinical diseases exclusively in humans. The distribution of emm type, antibiotic resistance and virulence gene expression for S. pyogenes varies temporally and geographically, resulting in distinct disease spectra. In this study, we analyzed antibiotic resistance and resistance gene expression patterns among S. pyogenes isolates from pediatric patients in China and investigated the relationship between virulence gene expression, emm type, and disease categories. Forty-two representative emm1.0 and emm12.0 strains (n = 20 and n = 22, respectively) isolated from patients with scarlet fever or obstructive sleep apnea-hypopnea syndrome were subjected to whole-genome sequencing and phylogenetic analysis. These strains were further analyzed for susceptibility to vancomycin. We found a high rate and degree of resistance to macrolides and tetracycline in these strains, which mainly expressed ermB and tetM. The disease category correlated with emm type but not superantigens. The distribution of vanuG and virulence genes were associated with emm type. Previously reported important prophages, such as φHKU16.vir, φHKU488.vir, Φ5005.1, Φ5005.2, and Φ5005.3 encoding streptococcal toxin, and integrative conjugative elements (ICEs) such as ICE-emm12 and ICE-HKU397 encoding macrolide and tetracycline resistance were found present amongst emm1 or emm12 clones from Shenzhen, China.

scholarly journals PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?

2013 ◽  
Vol 4 (4) ◽  
pp. 5 ◽  
Author(s):  
Usman Hadi ◽  
Kuntaman Kuntaman ◽  
Mariyatul Qiptiyah ◽  
Hari Paraton
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Teaching Hospitals ◽  
Resistant Bacteria ◽  
Prevention Study ◽  
Antibiotic Resistant ◽  
Inappropriate Use ◽  
Government Hospitals ◽  
Inappropriate Antibiotics ◽  
Very High

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.

scholarly journals Penatalaksanaan early childhood caries Management of early childhood caries

2011 ◽  
Vol 10 (3) ◽  
pp. 179
Author(s):  
Fajriani Fajriani ◽  
Hendrastuty Handayani
Keyword(s):  
Early Childhood ◽  
Early Childhood Caries ◽  
Dental Hygiene ◽  
Treatment Plan ◽  
High Rate ◽  
Tooth Decay ◽  
Inappropriate Use ◽  
Caries Management ◽  
Dental Diseases ◽  
Childhood Caries

Early childhood caries (ECC), also known as milk bottle caries is a syndrome of severe tooth decay, occurs ininfants and children, is an infectious disease that develops rapidly and lead to health problems in children. Thissyndrome can be caused by inappropriate use of bottles. Most cases of untreated ECC to children aged 20 months.At this stage many children need serious treatment, because this will result in trauma to both the children andparents. The most common treatment ECC and other dental diseases have been included in each treatment ofdisease. Efforts to educate families about dental hygiene and practice start a diet, the high rate of recurrence of anyevidence of disease ranging from tooth decay to the failure of the treatment plan resulted in the need for specialattention to this disease. This paper is expected to be a good input for a dentist in the treatment of ECC

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