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一项评估加纳医院头孢曲松处方情况的试点研究:结果与启示

A pilot study evaluating the prescribing of ceftriaxone in hospitals in Ghana: findings and implications.

作者信息

Afriyie Daniel Kwame, Amponsah Seth Kwabena, Dogbey Justice, Agyekum Kwabena, Kesse Samuel, Truter Ilse, Meyer Johanna C, Godman Brian

机构信息

a Pharmacy Department , Ghana Police Hospital , Accra , Ghana.

b Department of Pharmacology and Toxicology , University of Ghana School of Pharmacy , Legon , Ghana.

出版信息

Hosp Pract (1995). 2017 Oct;45(4):143-149. doi: 10.1080/21548331.2017.1348139. Epub 2017 Jul 13.

Abstract

BACKGROUND AND OBJECTIVES

Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone, widely used among hospitals including those in Ghana.

METHODS

A cross-sectional study to evaluate the appropriateness of ceftriaxone prescribing in a leading hospital in Ghana. Ceftriaxone prescribing in patient-record cards was assessed using a modified WHO drug-utilization evaluation criteria as well as referencing the national standard treatment guidelines in Ghana and the ceftriaxone package insert.

RESULTS

A total of 251 patients were assessed. Ceftriaxone was most commonly prescribed for comorbid malaria with bacterial infections, urinary tract infections, sepsis and gastroenteritis. The appropriateness of the indication was 86% (n = 218). The doses most prescribed were 1g (41%) and 2g (39%). Stat dose and once-daily dosage regimen constituted 51.4% and 84.5%, respectively. The most common duration of treatment was 1 (51.4%) and 2 days (35.1%). The overall appropriateness of prescribing was 93% against a pre-set threshold of 97%.

CONCLUSION

The appropriateness of ceftriaxone prescribing was high in this leading hospital in Ghana; however, there is room for improvement with targeted education initiatives, with further research planned.

摘要

背景与目的

抗生素的广泛经验性使用普遍存在,尤其是在发展中国家。这令人担忧,因为抗生素的不当使用,包括长期不当使用,会提高耐药率。因此,有必要评估各医疗部门的抗生素使用情况,以改善未来的使用。这包括头孢曲松,它在包括加纳医院在内的众多医院中广泛使用。

方法

一项横断面研究,旨在评估加纳一家主要医院头孢曲松处方的合理性。使用修改后的世界卫生组织药物利用评估标准,并参考加纳国家标准治疗指南和头孢曲松药品说明书,对患者病历卡中的头孢曲松处方进行评估。

结果

共评估了251名患者。头孢曲松最常用于合并疟疾与细菌感染、尿路感染、败血症和肠胃炎。适应证的合理性为86%(n = 218)。最常开具的剂量为1g(41%)和2g(39%)。静脉推注剂量和每日一次给药方案分别占51.4%和84.5%。最常见的治疗时长为1天(占51.4%)和2天(占35.1%)。与预设阈值97%相比,处方的总体合理性为93%。

结论

在加纳这家主要医院,头孢曲松处方的合理性较高;然而,通过有针对性的教育举措仍有改进空间,且计划开展进一步研究。

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