Mikhael Ehab Mudher, Jasim Ali Lateef
Clinical Pharmacy Department, College of Pharmacy, Baghdad University, Baghdad, Iraq.
Patient Prefer Adherence. 2014 Nov 26;8:1647-51. doi: 10.2147/PPA.S73401. eCollection 2014.
During Ramadan, Muslims fast throughout daylight hours. There is a direct link between fasting and increasing incidence of infections. Antibiotic usage for treatment of infections should be based on accurate diagnosis, with the correct dose and dosing regimen for the shortest period to avoid bacterial resistance. This study aimed to evaluate the practices of physicians in prescribing suitable antibiotics for fasting patients and the compliance of the patients in using such antibiotics at regular intervals.
An observational study was carried out during the middle 10 days of Ramadan 2014 in two pharmacies at Baghdad. A total of 34 prescriptions (Rx) for adults who suffered from infections were examined. For each included Rx, the researchers documented the age and sex of the patient, the diagnosis of the case, and the name of the given antibiotic(s) with dose and frequency of usage. A direct interview with the patient was also done, at which each patient was asked about fasting and if he/she would like to continue fasting during the remaining period of Ramadan. The patient was also asked if the physician asked him/her about fasting before writing the Rx.
More than two-thirds of participating patients were fasting during Ramadan. Antibiotics were prescribed at a higher percentage by dentists and surgeons, for which a single antibiotic with a twice-daily regimen was the most commonly prescribed by physicians for patients during the Ramadan month.
Physicians fail to take patient fasting status into consideration when prescribing antibiotics for their fasting patients. Antibiotics with a twice-daily regimen are not suitable and best to be avoided for fasting patients in Iraq during Ramadan - especially if it occurs during summer months - to avoid treatment failure and provoking bacterial resistance.
在斋月期间，穆斯林从黎明至日落禁食。禁食与感染发生率增加之间存在直接联系。用于治疗感染的抗生素使用应基于准确诊断，采用正确剂量并在最短时间内使用合适的给药方案，以避免细菌耐药性。本研究旨在评估医生为禁食患者开具合适抗生素的做法以及患者定期使用此类抗生素的依从性。
2014年斋月中旬在巴格达的两家药店进行了一项观察性研究。共检查了34份成年感染患者的处方。对于每份纳入的处方，研究人员记录了患者的年龄和性别、病例诊断以及所用抗生素的名称、剂量和使用频率。还对患者进行了直接访谈，询问每位患者是否禁食以及在斋月剩余期间是否愿意继续禁食。同时还询问患者医生在开处方前是否询问过其禁食情况。
超过三分之二的参与患者在斋月期间禁食。牙医和外科医生开具抗生素的比例较高，在斋月期间医生最常为患者开具的是每日两次服用的单一抗生素。
医生在为禁食患者开抗生素时未考虑患者的禁食状态。在伊拉克斋月期间，每日两次服用的抗生素不适合禁食患者，最好避免使用——尤其是在夏季——以避免治疗失败和引发细菌耐药性。
