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尼日利亚北部一家教学医院住院儿童的处方模式及抗生素使用情况

Prescribing pattern and antibiotic use for hospitalized children in a Northern Nigerian Teaching Hospital.

作者信息

Umar Lawal Waisu, Isah Abdulmuminu, Musa Shuaibu, Umar Bilkisu

机构信息

Department of Paediatrics, Ahmadu Bello University, Zaria, Nigeria.

Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria.

出版信息

Ann Afr Med. 2018 Jan-Mar;17(1):26-32. doi: 10.4103/aam.aam_44_17.

Abstract

BACKGROUND

Assessment of patterns of drug to detect performance problems and compliance with standards facilitates objective comparisons and impact evaluation. Children are at higher risk of consequences of irrational prescribing and antibiotic misuse.

OBJECTIVE

The objective of the study was to evaluate the prescribing pattern and utilization of antibiotics for children using standard prescribing indicators and indices of rational drug prescribing.

MATERIALS AND METHODS

This was a retrospective study of prescriptions for pediatric inpatients at a teaching hospital in Northern Nigeria. Information was obtained from eligible prescriptions received over 24-month period using a modified WHO prescribing indicator form. The WHO prescribing indicators and the Index of Rational Drug Prescribing (IRDP) were used to evaluate prescriptions. Data were analyzed and presented as proportions, means, tables, and charts, comparing with WHO standards and with findings of similar studies.

RESULTS

There were 3908 eligible prescription orders, with a mean patient age of 3.1 (±2.7) years. With an average of 2.1 drugs per prescription, 66.8% were written with generic names, whereas a single antibiotic was included among 63% of prescriptions with antibiotics. Antibiotics and injections were contained in 49.5% and 67.7% of prescriptions, respectively. Medications were available in the Essential Medicines List in 95.5% of cases. The IRDP obtained is 2.99, against a standard of 5. Aminoglycosides, cephalosporins, and penicillins were the most common choices, whereas ampicillin/cloxacillin was the most common combination.

CONCLUSION

Drug prescribing and antibiotic use were generally inappropriate compared with ideal standards. Continuous training/retraining on rational drug use, periodic monitoring, and use of treatment protocols in tertiary hospitals are recommended.

摘要

背景

评估药物使用模式以发现性能问题并符合标准有助于进行客观比较和影响评估。儿童面临不合理处方和抗生素滥用后果的风险更高。

目的

本研究的目的是使用标准处方指标和合理用药指标评估儿童抗生素的处方模式和使用情况。

材料与方法

这是一项对尼日利亚北部一家教学医院儿科住院患者处方的回顾性研究。使用修改后的世界卫生组织处方指标表格,从24个月期间收到的符合条件的处方中获取信息。使用世界卫生组织处方指标和合理用药指数(IRDP)评估处方。分析数据并以比例、均值、表格和图表形式呈现,与世界卫生组织标准以及类似研究的结果进行比较。

结果

有3908份符合条件的处方订单,患者平均年龄为3.1(±2.7)岁。每张处方平均使用2.1种药物,66.8%的处方使用通用名开具,而63%含抗生素的处方中仅包含一种抗生素。分别有49.5%和67.7%的处方含有抗生素和注射剂。95.5%的病例中药物在基本药物清单中可用。获得的IRDP为2.99,而标准为5。氨基糖苷类、头孢菌素类和青霉素类是最常用的选择,而氨苄西林/氯唑西林是最常见的组合。

结论

与理想标准相比,药物处方和抗生素使用总体上不合适。建议在三级医院持续开展合理用药培训/再培训、定期监测并使用治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3f0/5810090/c4d6a18ed9ca/AAM-17-26-g001.jpg

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