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巴基斯坦拉合尔医护人员抗生素配药/开处方行为以及对抗菌素耐药性(AMR)的知识和认知的形成性评估

A Formative Assessment of Antibiotic Dispensing/Prescribing Practices and Knowledge and Perceptions of Antimicrobial Resistance (AMR) among Healthcare Workers in Lahore Pakistan.

作者信息

Rakhshani Noor Sabah, Kaljee Linda Marie, Khan Mohammad Imran, Prentiss Tyler, Turab Ali, Mustafa Ali, Khalid Memoona, Zervos Marcus

机构信息

PHC Global (pvt.) Ltd., 241 Bahadur Shah Zafar Road, Bahadurabad 3, Karachi 74800, Pakistan.

Global Health Initiative, Henry Ford Health, One Ford Place, Suite 1E, Detroit, MI 48202, USA.

出版信息

Antibiotics (Basel). 2022 Oct 16;11(10):1418. doi: 10.3390/antibiotics11101418.

Abstract

(1) Background: Antimicrobial resistance causes significant disease burden in low- and middle-income countries. The objective of this paper is to describe antibiotic dispensing/prescribing practices and underlying factors associated with these practices among community-based healthcare workers. (2) Methods: Cross-sectional survey data were collected from private and public health facilities in 14 union councils, Lahore Pakistan. Respondents included physicians, nurses, lady health workers/volunteers, midwives, pharmacy and medicine shop employees, and medical technicians. Descriptive and bivariate analysis are used to present the data; (3) Results: 177 respondents completed the survey. In terms of weekly dispensing of antibiotics, the most common were Amoxicillin/Augmentin (2.3 [SD 1.5]), Cefixine (2.4 [SD 1.6]), and Azithromycin (2.5 [SD 2.1]). For children, antibiotics were more likely to be prescribed/dispensed for sore throat (54.3%/95) and diarrhea (48.9%/86). For adults, antibiotics were more likely to be prescribed/dispensed for sore throat (67.0%/118), diarrhea (59.7%/105) and burning sensation when urinating (55.7%/176). In total, 55.4% of respondents stated that they have sold partial antibiotic courses to patients/customers. A total of 44.6% of respondents incorrectly answered that antibiotics could be used for viral infections; (4) Conclusions: Data from this study and similar research emphasize the urgent need to implement community-based stewardship programs for all healthcare workers.

摘要

(1) 背景:抗菌药物耐药性在低收入和中等收入国家造成了重大疾病负担。本文的目的是描述社区医护人员的抗生素配药/开处方行为以及与这些行为相关的潜在因素。(2) 方法:从巴基斯坦拉合尔14个联合委员会的私立和公立卫生机构收集横断面调查数据。受访者包括医生、护士、女性卫生工作者/志愿者、助产士、药房和药店员工以及医学技术人员。使用描述性和双变量分析来呈现数据;(3) 结果:177名受访者完成了调查。在抗生素的每周配药方面,最常见的是阿莫西林/奥格门汀(2.3 [标准差1.5])、头孢克肟(2.4 [标准差1.6])和阿奇霉素(2.5 [标准差2.1])。对于儿童,因喉咙痛(54.3%/95)和腹泻(48.9%/86)而更有可能被开处方/配药。对于成年人,因喉咙痛(67.0%/118)、腹泻(59.7%/105)和排尿时有烧灼感(55.7%/176)而更有可能被开处方/配药。总体而言,55.4%的受访者表示他们曾向患者/客户出售过部分抗生素疗程。共有44.6%的受访者错误地回答抗生素可用于病毒感染;(4) 结论:本研究及类似研究的数据强调了为所有医护人员实施基于社区的管理计划的迫切需要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ec/9598410/f303a066f5b5/antibiotics-11-01418-g001.jpg

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