Antibiotic Prescribing Practice in Management of Cough And/or Diarrhoea in Moshi Municipality, Northern Tanzania: Cross-Sectional Descriptive Study.
Antibiotic prescribing practice in management of cough and/or diarrhoea in Moshi Municipality, Northern Tanzania: cross-sectional descriptive study.
Filed under: Drug and Alcohol Rehabilitation
Pan Afr Med J. 2012; 12: 103
Gwimile JJ, Shekalaghe SA, Kapanda GN, Kisanga ER
The increase in resistance of many pathogens to currently available antibiotics has been recognized as life-threatening problem. The development of drug resistance is promoted by irrational prescribing behavior. Inappropriate use of antibiotics is attributed by over-prescription, inadequate dosage and use for non-bacterial infections. The purpose of this study was to assess antibiotic prescribing practices in the management of diarrhoea and cough among children attending hospitals in Moshi municipal, Tanzania.We conducted a cross-sectional descriptive hospital based study, from September 2010 to March 2011. All children presenting with diarrhoea and cough, aged between one month and 5years attended at the two hospitals were enrolled. Data were collected by a standard questionnaire. Information on the prescribed drugs was obtained from patient files.A total of 384 children were enrolled. Of these, 326 (84.9%) received antibiotics; common prescribed antibiotics were penicillins, sulphonamides, aminoglycosides and macrolides. Eighty percent of children with acute watery diarrhoea and 68.9% with common cold were given antibiotics inappropriately. Inappropriate antibiotic prescription was significantly associated with prescriber being a clinical officer and assistant medical officer, and child having diarrhoea. Inappropriate antibiotic dosage was significantly occurred when prescriber was clinical officer with reference to medical officer.This study observed a high antibiotic prescription rate by clinicians and treatment guidelines for management of patients who presented with cough and/or diarrhoea are followed. Continuing professional development programmes for clinicians on prescription would help in reducing irrational prescribing practices.
HubMed – drug
The managed hypertensive: the costs of blood pressure control in a Nigerian town.
Filed under: Drug and Alcohol Rehabilitation
Pan Afr Med J. 2012; 12: 96
Ilesanmi OS, Ige OK, Adebiyi AO
The health systems designed to cater for patients with chronic illnesses like hypertension have not fully evaluated the burden of long term therapy and its effect on patient outcome. This study assessed the financial implication and cost effectiveness of hypertension treatment in a rural Nigerian town.A chart review of 250 rural patients with primary hypertension at a regional hospital in Southwest Nigeria was conducted.The mean age of patients was 61±11.2 years, 59.2% were females, 67% had an income < ?20,000 ($ 133.3) monthly. Diuretics and alpha-Methyl Dopa were the most prescribed drugs. The median number of prescribed drugs was two (range1-4). Mean cost of treatment was ?1440±560 ($ 9.6±3.7) with 52.8% spending ???? 10% of their income on treatment. The most cost effective therapies were Methyl Dopa and Diuretics with Cost-effectiveness ratios of 8 and 12.8 respectively. Patients with co-morbidities, stage 2 hypertension and those on three or four drug regimen had significantly higher treatment costs.The financial burden of long term antihypertensive therapy appears substantial, cost reduction strategies are needed to optimize hypertension treatment in societies with limited resources. Hypertensive management therefore requires a response adapted to the local context. HubMed – drug
Relative Neurotoxicity of Ivermectin and Moxidectin in Mdr1ab (-/-) Mice and Effects on Mammalian GABA(A) Channel Activity.
Filed under: Drug and Alcohol Rehabilitation
PLoS Negl Trop Dis. 2012 Nov; 6(11): e1883
Ménez C, Sutra JF, Prichard R, Lespine A
The anthelmintics ivermectin (IVM) and moxidectin (MOX) display differences in toxicity in several host species. Entrance into the brain is restricted by the P-glycoprotein (P-gp) efflux transporter, while toxicity is mediated through the brain GABA(A) receptors. This study compared the toxicity of IVM and MOX in vivo and their interaction with GABA(A) receptors in vitro. Drug toxicity was assessed in Mdr1ab(-/-) mice P-gp-deficient after subcutaneous administration of increasing doses (0.11-2.0 and 0.23-12.9 µmol/kg for IVM and MOX in P-gp-deficient mice and half lethal doses (LD(50)) in wild-type mice). Survival was evaluated over 14-days. In Mdr1ab(-/-) mice, LD(50) was 0.46 and 2.3 µmol/kg for IVM and MOX, respectively, demonstrating that MOX was less toxic than IVM. In P-gp-deficient mice, MOX had a lower brain-to-plasma concentration ratio and entered into the brain more slowly than IVM. The brain sublethal drug concentrations determined after administration of doses close to LD(50) were, in Mdr1ab(-/-) and wild-type mice, respectively, 270 and 210 pmol/g for IVM and 830 and 740-1380 pmol/g for MOX, indicating that higher brain concentrations are required for MOX toxicity than IVM. In rat ?1?2?2 GABA channels expressed in Xenopus oocytes, IVM and MOX were both allosteric activators of the GABA-induced response. The Hill coefficient was 1.52±0.45 for IVM and 0.34±0.56 for MOX (p<0.001), while the maximum potentiation caused by IVM and MOX relative to GABA alone was 413.7±66.1 and 257.4±40.6%, respectively (p<0.05), showing that IVM causes a greater potentiation of GABA action on this receptor. Differences in the accumulation of IVM and MOX in the brain and in the interaction of IVM and MOX with GABA(A) receptors account for differences in neurotoxicity seen in intact and Mdr1-deficient animals. These differences in neurotoxicity of IVM and MOX are important in considering their use in humans. HubMed – drug
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