scholarly journals Antibiotic choice in UK general practice: rates and drivers of potentially inappropriate antibiotic prescribing

2019 ◽  
Vol 74 (11) ◽  
pp. 3371-3378 ◽  
Author(s):  
Magdalena Nowakowska ◽  
Tjeerd van Staa ◽  
Anna Mölter ◽  
Darren M Ashcroft ◽  
Jung Yin Tsang ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Otitis Media ◽  
Otitis Externa ◽  
Antibiotic Prescribing ◽  
Practice Level ◽  
Clustering Effect ◽  
Tract Infections ◽  
To Receive

Abstract Objectives To identify the rates of potentially inappropriate antibiotic choice when prescribing for common infections in UK general practices. To examine the predictors of such prescribing and the clustering effects at the practice level. Methods The rates of potentially inappropriate antibiotic choice were estimated using 1 151 105 consultations for sinusitis, otitis media and externa, upper respiratory tract infection (URTI) and lower respiratory tract infection (LRTI) and urinary tract infection (UTI), using the Clinical Practice Research Datalink (CPRD). Multilevel logistic regression was used to identify the predictors of inappropriate prescribing and to quantify the clustering effect at practice level. Results The rates of potentially inappropriate prescriptions were highest for otitis externa (67.3%) and URTI (38.7%) and relatively low for otitis media (3.4%), sinusitis (2.2%), LRTI (1.5%) and UTI in adults (2.3%) and children (0.7%). Amoxicillin was the most commonly prescribed antibiotic for all respiratory tract infections, except URTI. Amoxicillin accounted for 62.3% of prescriptions for otitis externa and 34.5% of prescriptions for URTI, despite not being recommended for these conditions. A small proportion of the variation in the probability of an inappropriate choice was attributed to the clustering effect at practice level (8% for otitis externa and 23% for sinusitis). Patients with comorbidities were more likely to receive a potentially inappropriate antibiotic for URTI, LRTI and UTI in adults. Patients who received any antibiotic in the 12 months before consultation were more likely to receive a potentially inappropriate antibiotic for all conditions except otitis externa. Conclusions Antibiotic prescribing did not always align with prescribing guidelines, especially for URTIs and otitis externa. Future interventions might target optimizing amoxicillin use in primary care.

scholarly journals Assessment of Antibiotic Prescription in Respiratory Tract Infection at Hera General Hospital in Makkah Almukarramah, KSA

2019 ◽  
Vol 4 (03) ◽  
Author(s):  
Rafea B. ◽  
Alharbi F. ◽  
Alhazmi G. ◽  
Alahmadi L. ◽  
Almotiri M. ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
General Hospital ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Acute Respiratory Tract Infections ◽  
Tract Infections

Introduction: In general practice, approximately two-thirds of antibiotic prescriptions are for respiratory tract infections. Acute respiratory tract infections, which include acute uncomplicated bronchitis, pharyngitis, rhinosinusitis and the common cold, are often common reasons for acute outpatient visits to physicians and antibiotic prescriptions for adults. The improper treatment of acute respiratory tract infections is now an urgent public health threat, as it is an important contributor to antibiotic resistance. In developing countries, including Saudi Arabia, antibiotics are prescribed excessively and are often obtained without prescription. Aim: The aim of this study was to gather information on current antibiotic prescribing rates for respiratory tract infection in Hera General Hospital Makkah Almukarramah, Saudi Arabia. Method: A cross-sectional study, incorporating systematic sampling on clinical data from antibiotic prescriptions in hospitalised and emergency departments at Hera General Hospital, was conducted. From September 2017 to April 2018, approximately 500 prescriptions were collected from each hospitalised and emergency pharmacy for patients with respiratory tract infections. Results: The most prescribed antibiotics for respiratory tract infections came from the penicillin group and ciprofloxacin. The prescribing of antibiotics for respiratory tract infections was more prevalent amongst males than females. Potential over-prescribing of antibiotics for upper respiratory tract infections specially patients with otitis media especially in children without proper lab investigations.

scholarly journals Systematic Review: Study of the Prescribing Pattern of Antibiotics in Outpatients and Emergency Departments in the Gulf Region

2020 ◽  
Vol 11 ◽  
Author(s):  
Rana Kamran Mahmood ◽  
Syed Wasif Gillani ◽  
Muhammad Waqas Saeed ◽  
Muhammad Umar Hafeez ◽  
Shabaz Muhammad Gulam
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Emergency Departments ◽  
Acute Respiratory Tract Infection ◽  
Antibiotic Prescribing ◽  
Gulf Region ◽  
Prescribing Pattern ◽  
English Articles ◽  
Tract Infections

Purpose: To study the prescribing pattern of antibiotics in outpatients and emergency departments in the Gulf region. To compare the appropriateness of prescriptions and antibiotics commonly prescribed for respiratory tract infection.Method: The search was limited to the years 2008–2020, and articles had to be in English. Articles were searched from various resources and evaluated using PRISMA. Forty-one articles were selected and screened, and in the end, 17 articles were included in the study. All articles were selected from the gulf region of six countries: UAE, Saudi Arabia, Qatar, Oman, Yemen, and Bahrain. Only primary literature were included. Inpatient and literature from other countries outside the gulf region were excluded.Result: Penicillins, cephalosporins, and macrolides are highly useful antibiotics for respiratory tract infections. Ceftriaxone IV is recommended in acute respiratory tract infection if therapy with penicillin fails. Most of the antibiotic prescriptions in Gulf countries are inappropriate. Inappropriate antibiotic prescribing in the gulf region varies from place to place and reaches a maximum of 80%. Antibiotics may be prescribed with the wrong dosage or frequency and inappropriate guidelines. Penicillins are prescribed at about 50–60%; the most common penicillins prescribed are amoxicillin and co-amoxiclave. Cephalosporins are prescribed at about 30%, and the most common are third-generation. Macrolides are prescribed at about 17–20%, and the most common macrolides are azithromycin and clarithromycin. Fluoroquinolones are prescribed at about 10–12%, of which levofloxacin and ciprofloxacin are more commonly prescribed with metronidazole at 10%.Conclusion: It is suggested that the antibiotic-prescribing pattern in outpatient and emergency departments in the Gulf region are highly inappropriate and need improvement through education, following guidelines, annual vaccination, and stewardship programs; the most prescribed antibiotic is amoxicillin/co-amoxiclave, and the most often encountered infection in outpatients is acute respiratory tract infection.

scholarly journals Public health messages about antibiotic treatment for respiratory tract infection may increase perceived symptom severity reporting

2016 ◽  
Vol 24 (5) ◽  
pp. 623-627 ◽  
Author(s):  
Claire Lawrence ◽  
Eamonn Ferguson
Keyword(s):  
Public Health ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Antibiotic Treatment ◽  
Symptom Severity ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Health Campaigns ◽  
Tract Infections

Public health campaigns to reduce expectations for antibiotic treatment for respiratory tract infections have shown little or no effect on antibiotic prescribing and consumption. We examined whether such messages can increase respiratory tract infection symptom reporting. Participants ( N = 318) received one of four campaign messages, a combination of all four messages, or no message. Respiratory tract infection symptoms increased for those who received information that emphasized the ineffectiveness of antibiotic treatment for respiratory tract infections. As symptom severity is associated with greater contact with primary healthcare and receiving antibiotic prescriptions, campaigns to encourage antimicrobial stewardship should consider the side effects of antibiotic ineffectiveness messages.

scholarly journals Toll-Like Receptors: Expression and Roles in Otitis Media

2021 ◽  
Vol 22 (15) ◽  
pp. 7868
Author(s):  
Su Young Jung ◽  
Dokyoung Kim ◽  
Dong Choon Park ◽  
Sung Soo Kim ◽  
Tong In Oh ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Otitis Media ◽  
Middle Ear ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Toll Like Receptors ◽  
Upper Respiratory

Otitis media is mainly caused by upper respiratory tract infection and eustachian tube dysfunction. If external upper respiratory tract infection is not detected early in the middle ear, or an appropriate immune response does not occur, otitis media can become a chronic state or complications may occur. Therefore, given the important role of Toll-like receptors (TLRs) in the early response to external antigens, we surveyed the role of TLRs in otitis media. To summarize the role of TLR in otitis media, we reviewed articles on the expression of TLRs in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. Many studies showed that TLRs 1–10 are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. TLR expression in the normal middle ear mucosa is absent or weak, but is increased in inflammatory fluid of AOM, effusion of OME, and granulation tissue and cholesteatoma of COM. In addition, TLRs show increased or decreased expression depending on the presence or absence of bacteria, recurrence of disease, tissue type, and repeated surgery. In conclusion, expression of TLRs is associated with otitis media. Inappropriate TLR expression, or delayed or absent induction, are associated with the occurrence, recurrence, chronicization, and complications of otitis media. Therefore, TLRs are very important in otitis media and closely related to its etiology.

scholarly journals Manejo perioperatorio de niños con infección respiratoria superior

2019 ◽  
Vol 67 (2) ◽  
pp. 341-347
Author(s):  
Norma Constanza Corrales-Zúñiga ◽  
Nelly Patricia Martínez-Muñoz ◽  
Sara Isabel Realpe-Cisneros ◽  
Carlos Eberth Pacichana-Agudelo ◽  
Leandro Guillermo Realpe-Cisneros ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infection ◽  
Cochrane Library ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Introducción. Es frecuente que muchos niños sometidos a procedimientos con anestesia general tengan historia de infección viral respiratoria superior reciente o activa.Objetivo. Realizar una revisión narrativa acerca de las pautas de manejo anestésico para los niños con infección reciente o activa de la vía aérea superior.Materiales y métodos. Se realizó una búsqueda estructurada de la literatura en las bases de datos ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip Database, SciELO y Cochrane Library con los términos Anesthesia AND Respiratory Tract Infections AND Complications; Anesthesia AND Upper respiratory tract infection AND Complications; Anesthesia, General AND Respiratory Tract Infections AND Complications; Anesthesia, General AND Upper respiratory tract infection AND Complications; Anesthesia AND Laryngospasm OR Bronchospasm. La búsqueda se hizo en inglés con sus equivalentes en español.Resultados. Se encontraron 56 artículos con información relevante para el desarrollo de la presente revisión.Conclusiones. Una menor manipulación de la vía aérea tiende a disminuir la frecuencia de aparición y severidad de eventos adversos respiratorios perioperatorios. No existe evidencia suficiente para recomendar la optimización medicamentosa en pacientes con infección respiratoria superior.

Effectiveness of Oral Rinse with Chlorhexidine in Preventing Nosocomial Respiratory Tract Infections among Intensive Care Unit Patients

2009 ◽  
Vol 30 (10) ◽  
pp. 952-958 ◽  
Author(s):  
Fernando Bellissimo-Rodrigues ◽  
Wanessa Teixeira Bellissimo-Rodrigues ◽  
Jaciara Machado Viana ◽  
Gil Cezar Alkmim Teixeira ◽  
Edson Nicolini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Respiratory Tract Infections ◽  
Icu Patients ◽  
Oral Application ◽  
Tract Infections

Objective.To evaluate the effectiveness of the oral application of a 0.12% solution of Chlorhexidine for prevention of respiratory tract infections among intensive care unit (ICU) patients.Design.The study design was a double-blind, randomized, placebo-controlled trial.Setting.The study was performed in an ICU in a tertiary care hospital at a public university.Patients.Study participants comprised 194 patients admitted to the ICU with a prospective length of stay greater than 48 hours, randomized into 2 groups: those who received Chlorhexidine (n = 98) and those who received a placebo (n = 96).Intervention.Oral rinses with Chlorhexidine or a placebo were performed 3 times a day throughout the duration of the patient's stay in the ICU. Clinical data were collected prospectively.Results.Both groups displayed similar baseline clinical features. The overall incidence of respiratory tract infections (RR, 1.0 [95% confidence interval [CI], 0.63-1.60]) and the rates of ventilator-associated pneumonia per 1,000 ventilator-days were similar in both experimental and control groups (22.6 vs 22.3; P = .95). Respiratory tract infection-free survival time (7.8 vs 6.9 days; P = .61), duration of mechanical ventilation (11.1 vs 11.0 days; P = .61), and length of stay (9.7 vs 10.4 days; P = .67) did not differ between the Chlorhexidine and placebo groups. However, patients in the Chlorhexidine group exhibited a larger interval between ICU admission and onset of the first respiratory tract infection (11.3 vs 7.6 days; P = .05). The chances of surviving the ICU stay were similar (RR, 1.08 [95% CI, 0.72-1.63]).Conclusion.Oral application of a 0.12% solution of Chlorhexidine does not prevent respiratory tract infections among ICU patients, although it may retard their onset.

scholarly journals IDENTIFICATION OF DRUG-RELATED PROBLEMS IN PATIENTS WITH UPPER ACUTE RESPIRATORY TRACT INFECTIONS IN TEBET SUBDISTRICT HEALTH CENTER

2020 ◽  
pp. 69-73
Author(s):  
ATIKA WAHYU PUSPITASARI ◽  
OLYVA CESSARI LARAS SERUNI ◽  
LINA NADHILAH
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Health Center ◽  
Drug Dosage ◽  
Upper Respiratory Tract ◽  
Drug Related Problems ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Tract Infections

Objective: Acute respiratory tract infection (ARTI) is common and has the highest death rate in children, especially in growing countries such asIndonesia. The aim of the research is to identify drug-related problems (DRPs) in pediatric ARTI patients based on the DRP classification by Cipolle,Strand, and Morley, which included categories such as unnecessary drug therapy, need additional therapy, ineffective drug, dosage adjustments suchas too low or too high, and adverse drug reaction which is drug interaction.Methods: The design of the study was cross-sectional and descriptive with a retrospective method. The sample of the study was the overall prescriptionsto upper respiratory tract infection patients in Tebet Subdistrict Health Center from July to December 2018 that fulfilled all of the inclusion criteria,using the total sampling method. Total samples that were analyzed were from 179 sheets of prescription with a total of 498 prescriptions.Results: The results of the research based on each parameter were inaccurate drug selection (9.5%), inaccurate indication (12.8%), mismatched dose(79.9%), and drug interaction (0.6%).Conclusion: DRPs in ARTI pediatric patients resulted in a high-risk condition so that the health facilities need to improve their prescribing pattern andmonitor and manage each therapy as well as do a routine prescription assessment to minimize the incidence of DRPs and achieve a rational drug usage.

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