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尼日利亚牙科门诊患者的药物处方模式:研究结果与启示

Patterns of drugs prescribed for dental outpatients in Nigeria: findings and implications.

作者信息

Fadare Joseph O, Oshikoya Kazeem A, Obimakinde Obitade S, Sijuade Abayomi O, Afolayan Jide M, Adeleke Adeyinka A, Godman Brian, Ojumu Damilola O

机构信息

a Department of Pharmacology and Therapeutics, College of Medicine , Ekiti State University , Ado-Ekiti , Nigeria.

b Department of Pharmacology, College of Medicine , Lagos State University , Lagos , Nigeria.

出版信息

Acta Odontol Scand. 2017 Oct;75(7):496-506. doi: 10.1080/00016357.2017.1347822. Epub 2017 Jul 11.

Abstract

OBJECTIVES

There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns.

METHODS AND MATERIALS

Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated. Patients referred for admission, without a prescription, or prescribed medicines without a documented diagnosis were excluded.

RESULTS

Overall, 607 prescriptions were analysed, 314 (51.7%) were for females. Periodontal and gum diseases (414; 68.1%) were the most frequent diagnoses, followed by pulpitis (49; 8.2%), and dentoalveolar abscess (43; 7.1%). A total of 1798 medicines were prescribed for all patients with a mean of 3.0 ± 0.48 medicines per prescription. Antimicrobials (1178; 65.5%) and analgesics (620; 34.5%) were the two drug classes prescribed. Ascorbic acid and vitamin B complex were prescribed for 361 (59.5%) patients. Among antimicrobials, amoxicillin (564; 95.1%) either alone or combined with clavulanic acid was the most frequently prescribed, followed by metronidazole (561; 94.6%). Brand name prescribing was also appreciably higher than WHO recommendations.

CONCLUSION

Polypharmacy, brand name prescriptions, and the frequent prescription of antimicrobials were common practices at the dental clinic of this teaching hospital in Nigeria. We suggest a review of the current standard treatment guidelines in Nigeria to guide dentists on current knowledge- and evidence-based treatment of common oral diseases.

摘要

目的

人们担心牙医不合理用药,尤其是抗菌药物。如果这会提高耐药率,那就更令人担忧了。本研究旨在通过评估尼日利亚一家医院牙科门诊患者的用药模式来解决这一问题。研究结果将用于规划未来的干预措施,特别是在存在担忧的抗菌药物处方方面。

方法和材料

对尼日利亚一家领先教学医院牙科门诊患者的病历进行了评估。被转诊入院、无处方或有处方但无诊断记录的患者被排除在外。

结果

总体而言,共分析了607份处方,其中314份(51.7%)是给女性患者的。牙周病和牙龈疾病(414例;68.1%)是最常见的诊断,其次是牙髓炎(49例;8.2%)和牙槽脓肿(43例;7.1%)。所有患者共开具了1798种药物,平均每张处方3.0±0.48种药物。开具的两类药物是抗菌药物(1178种;65.5%)和镇痛药(620种;34.5%)。361名(59.5%)患者开具了抗坏血酸和复合维生素B。在抗菌药物中,阿莫西林(564种;95.1%)单独使用或与克拉维酸联合使用是最常开具的,其次是甲硝唑(561种;94.6%)。品牌药处方也明显高于世界卫生组织的建议。

结论

在尼日利亚这家教学医院的牙科门诊,联合用药、品牌药处方以及频繁开具抗菌药物是常见做法。我们建议对尼日利亚目前的标准治疗指南进行审查,以指导牙医对常见口腔疾病进行基于当前知识和证据的治疗。

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