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埃及社区药店的抗生素配药情况:一项观察性研究。

Antibiotic dispensing in Egyptian community pharmacies: an observational study.

机构信息

Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.

出版信息

Res Social Adm Pharm. 2014 Jan-Feb;10(1):168-84. doi: 10.1016/j.sapharm.2013.03.004. Epub 2013 May 10.

Abstract

BACKGROUND

Antibiotics are commonly dispensed medications from community pharmacies, and they are frequently prescribed for inappropriate indications. In many countries, they are easily accessible without prescriptions. The inappropriate use of antibiotics results in the emergence of resistant bacterial strains, which represents a considerable public health problem, particularly in developing countries.

OBJECTIVE

This study aimed to describe the pattern of antibiotics dispensing from Egyptian community pharmacies and to collect baseline descriptive data on the antibiotics dispensed and their appropriateness.

METHODS

A cross-sectional, observational study of antibiotic dispensing encounters was conducted at 36 randomly selected pharmacies in Greater Cairo, Egypt. Data were collected during one shift at each pharmacy. Structured questionnaires recording patient demographics, antibiotics dispensed and reasons for dispensing were completed for each antibiotic dispensing encounter. The data were descriptively analysed.

RESULTS

Overall, 1158 antibiotics were dispensed during the study period with a total cost of L.E. 24,487 (approximately 3,673 $USD). While self-medication and purchasing without medical prescriptions were common, representing around 23.3% of the antibiotics (n = 270), most antibiotics were prescribed by a doctor or dentist (n = 736, 63.6%). Pharmacist recommendations accounted for the remainder (n = 152, 13.1%). The main reasons for antibiotic use were respiratory tract ailments and gastroenteritis symptoms. The antibiotics most commonly dispensed were: penicillins, erythromycin, metronidazole, neomycin, clotrimoxazole and tetracyclines. Approximately 70% of the antibiotics dispensed on prescriptions were judged to be appropriate for the indications while this percentage was around 61% for antibiotics dispensed on pharmacist recommendation and patient's request.

CONCLUSIONS

The results of this study show that antibiotics are frequently dispensed from community pharmacies in Egypt without appropriate prescriptions and for inappropriate indications. These findings support the need for strict enforcement of pharmacy laws through improved inspection processes. They highlight the need for evidence-based guidelines and educational interventions to improve antibiotic prescribing and dispensing practices.

摘要

背景

抗生素是社区药店常用的处方药物,经常被用于不适当的适应证。在许多国家,抗生素无需处方即可轻易获得。抗生素的不适当使用导致了耐药菌株的出现,这是一个相当严重的公共卫生问题,特别是在发展中国家。

目的

本研究旨在描述埃及社区药店抗生素配药模式,并收集有关配药抗生素及其适当性的基线描述性数据。

方法

在埃及大开罗地区的 36 家随机选择的药店进行了一项横断面、观察性的抗生素配药情况研究。在每个药店的一个班次期间收集数据。为每个抗生素配药情况记录了患者人口统计学数据、配药抗生素和配药原因的结构化问卷。对数据进行了描述性分析。

结果

总体而言,在研究期间共配药 1158 种抗生素,总费用为 24487 埃镑(约合 3673 美元)。虽然自我用药和无医疗处方购买很常见,占抗生素的 23.3%(n=270),但大多数抗生素是由医生或牙医开的(n=736,占 63.6%)。药剂师的建议占其余部分(n=152,占 13.1%)。抗生素使用的主要原因是呼吸道疾病和胃肠炎症状。配药最常见的抗生素是:青霉素、红霉素、甲硝唑、新霉素、克霉唑和四环素。约 70%的处方配药抗生素被认为适用于适应证,而根据药剂师建议和患者要求配药的抗生素这一比例约为 61%。

结论

本研究结果表明,在埃及,抗生素经常在没有适当处方的情况下从社区药店配给,且适应证不适当。这些发现支持通过改进检查程序严格执行药房法律的必要性。它们强调需要基于证据的指南和教育干预措施,以改善抗生素处方和配药实践。

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