scholarly journals Hajj Specific Appropriate Medication and Antibiotic Prescription: A Call for Development

2021 ◽  
pp. 134-136
Author(s):  
Hamid Bokhary ◽  
Osamah Barasheed
Keyword(s):  
Antibiotic Prescription

Antibiotic Prescription Practices of Pediatricians and Pediatric Residents in Hospital Care in Greece

2015 ◽  
Vol 10 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Mary Geitona ◽  
Aikaterini Toska ◽  
Kyriakos Souliotis ◽  
Maria Saridi ◽  
Costas Demetzos
Keyword(s):  
Hospital Care ◽  
Antibiotic Prescription ◽  
Pediatric Residents ◽  
Prescription Practices

scholarly journals A game theoretic approach reveals that discretizing clinical information can reduce antibiotic misuse

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Maya Diamant ◽  
Shoham Baruch ◽  
Eias Kassem ◽  
Khitam Muhsen ◽  
Dov Samet ◽  
...  
Keyword(s):  
Antibiotic Prescription ◽  
Clinical Information ◽  
Social Optimum ◽  
Theoretic Approach ◽  
Theoretic Analysis ◽  
Game Theoretic Analysis ◽  
Optimal Output ◽  
The Social ◽  
Game Theoretic ◽  
Game Theoretic Approach

AbstractThe overuse of antibiotics is exacerbating the antibiotic resistance crisis. Since this problem is a classic common-goods dilemma, it naturally lends itself to a game-theoretic analysis. Hence, we designed a model wherein physicians weigh whether antibiotics should be prescribed, given that antibiotic usage depletes its future effectiveness. The physicians’ decisions rely on the probability of a bacterial infection before definitive laboratory results are available. We show that the physicians’ equilibrium decision rule of antibiotic prescription is not socially optimal. However, we prove that discretizing the information provided to physicians can mitigate the gap between their equilibrium decisions and the social optimum of antibiotic prescription. Despite this problem’s complexity, the effectiveness of the discretization solely depends on the type of information available to the physician to determine the nature of infection. This is demonstrated on theoretic distributions and a clinical dataset. Our results provide a game-theory based guide for optimal output of current and future decision support systems of antibiotic prescription.

scholarly journals Implementation of C-reactive protein point of care testing to improve antibiotic targeting in respiratory illness in Vietnamese primary care (ICAT): a study protocol for a cluster randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040977
Author(s):  
Nga Thi Thuy Do ◽  
Rachel Claire Greer ◽  
Yoel Lubell ◽  
Sabine Dittrich ◽  
Maida Vandendorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Antibiotic Prescription ◽  
Point Of Care ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Antibiotic Use ◽  
Routine Care ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Randomised Controlled

IntroductionC-reactive protein (CRP), a biomarker of infection, has been used widely in high-income settings to guide antibiotic treatment in patients presenting with respiratory illnesses in primary care. Recent trials in low- and middle-income countries showed that CRP testing could safely reduce antibiotic use in patients with non-severe acute respiratory infections (ARIs) and fever in primary care. The studies, however, were conducted in a research-oriented context, with research staff closely monitoring healthcare behaviour thus potentially influencing healthcare workers’ prescribing practices. For policy-makers to consider wide-scale roll-out, a pragmatic implementation study of the impact of CRP point of care (POC) testing in routine care is needed.Methods and analysisA pragmatic, cluster-randomised controlled trial, with two study arms, consisting of 24 commune health centres (CHC) in the intervention arm (provision of CRP tests with additional healthcare worker guidance) and 24 facilities acting as controls (routine care). Comparison between the treatment arms will be through logistic regression, with the treatment assignment as a fixed effect, and the CHC as a random effect. With 48 clusters, an average of 10 consultations per facility per week will result in approximately 520 over 1 year, and 24 960 in total (12 480 per arm). We will be able to detect a reduction of 12% to 23% or more in immediate antibiotic prescription as a result of the CRP POC intervention. The primary endpoint is the proportion of patient consultations for ARI resulting in immediate antibiotic prescription. Secondary endpoints include the proportion of all patients receiving an antibiotic prescription regardless of ARI diagnosis, frequency of re-consultation, subsequent antibiotic use when antibiotics are not prescribed, referral and hospitalisation.Ethics and disseminationThe study protocol was approved by the Oxford University Tropical Research Ethics Committee (OxTREC, Reference: 53–18), and the ethical committee of the National Hospital for Tropical Diseases in Vietnam (Reference:07/HDDD-NDTW/2019). Results from this study will be disseminated via meetings with stakeholders, conferences and publications in peer-reviewed journals. Authorship and reporting of this work will follow international guidelines.Trial registration detailsNCT03855215; Pre-results.

scholarly journals Antibiotic prescription for febrile outpatients: a health facility-based secondary data analysis for the Greater Accra region of Ghana

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michael Mireku Opoku ◽  
Harriet Affran Bonful ◽  
Kwadwo Ansah Koram
Keyword(s):  
Antibiotic Prescription ◽  
Secondary Data ◽  
Health Facilities ◽  
Full Blood Count ◽  
Baseline Survey ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Factors Associated ◽  
Laboratory Investigations ◽  
Greater Accra Region

Abstract Background Misguided prescription of antibiotics is an important contributor towards the emergence and spread of antibiotic resistance. The absence of effective interventions to control antibiotic use leads to increased consumption beyond the needed requirements. Antibiotic stewardship interventions must be appropriately targeted and assessed to enhance the controlled use of antibiotics. The objective of this study was to determine the factors associated with antibiotic prescription to febrile outpatients who seek care in health facilities within the Greater Accra region of Ghana. Methods Secondary data obtained from the medical records of 2519 febrile outpatients, consecutively sampled at the outpatient department of 6 health facilities in 3 municipalities during the baseline survey of a quasi-experiment in 2015 was used. The primary outcome was prescription of any antibiotic. Independent variables included patients’ demographics, symptoms, laboratory investigations (blood film microscopy, malaria rapid diagnostic test, full blood count, urine and stool routine examinations), diagnoses, and prescribers’ demographics. Crude and adjusted logistic regression analyses were used to determine the factors associated with antibiotic prescription. Results The prevalence of antibiotic prescription was 70.1% (95% CI: 67.7–72.4). Prescribers with more years of practice (> 5 years) were more likely to prescribe antibiotics compared to those with less than 3 years of practice (p <  0.001). Integrated Management of Neonatal and Childhood Illnesses (IMNCI) training was associated with a 2.3 (95% CI: 1.54, 3.53, p <  0.001) fold odds of antibiotic prescribing. Patients aged 5 years or more were 60% less likely to receive antibiotics compared with those under 5 years (AOR = 0.40, 95% CI: 0.32, 0.51; p <  0.001). Patients referred for laboratory investigations were 29% less likely to be prescribed antibiotics than those not referred. The presence of cough as a presenting symptom was associated with a 3.5 (95% CI: 2.54, 4.92) fold odds of antibiotic prescription. Conclusion Prescription of antibiotics to febrile outpatients was high. Promoting laboratory testing can potentially reduce irrational antibiotic prescription. Prescribing antibiotics for children under five and the prescribing practices of prescribers with longer years of practice should be targeted with interventions to reduce high use of antibiotics.

scholarly journals Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

2021 ◽  
pp. 1-8
Author(s):  
Wendy Thompson ◽  
Leanne Teoh ◽  
Colin C. Hubbard ◽  
Fawziah Marra ◽  
David M. Patrick ◽  
...  
Keyword(s):  
United States ◽  
British Columbia ◽  
Broad Spectrum ◽  
Antibiotic Prescription ◽  
Population Level ◽  
The United States ◽  
Antibiotic Prescribing ◽  
Prescribing Behavior ◽  
The Us ◽  
Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

scholarly journals The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam Mohsen Aly ◽  
Marwa Aly Elchaghaby
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Prescription ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
General Dentists

Abstract Background The use of antibiotics in dentistry as prophylaxis and treatment is frequent. Their misuse has led to a major public health problem globally known as antibiotic resistance. This study aimed to assess the pattern of antibiotic prescription and its prophylactic use for systemic conditions. Besides, this study evaluated the awareness and adherence to antibiotic prescription guidelines and antibiotic prophylaxis guidelines along with awareness of antibiotic resistance across pediatric and general dentists. Methods An overall of 378 pediatric and general dentists meeting the required eligibility criteria, fulfilled a pre-designed validated questionnaire. Data were collected, tabulated, and statistically analyzed. Results A significant statistical difference was found among the pediatric and general dentists regarding antibiotics prescription for most of the oral conditions where Amoxicillin with clavulanic acid was the most frequently prescribed antibiotic among the two groups (53% pediatric dentist and 52% general dentist). The majority of pediatric and general dentists, on the other hand, were aware of antibiotic resistance and prescribing recommendations. Conclusions The present study showed a tendency to overprescribe and overuse antibiotics in certain dental conditions among the participants. The vast majority of dentists, especially general dentists do not have adherence to professional guidelines for antibiotics prescription in children despite their awareness of antibiotic resistance and prescription guidelines.

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