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Titolo:
Antibiotic dispensing by drug retailers in Kathmandu, Nepal
Autore:
Wachter, DA; Joshi, MP; Rimal, B;
Indirizzi:
Univ New Mexico, Sch Med, Dept Emergency Med, Ambulatory Care Ctr W 4, Albuquerque, NM 87131 USA Univ New Mexico Albuquerque NM USA 87131 r W 4, Albuquerque, NM 87131 USA Tribhuvan Univ, Teaching Hosp, Inst Med, Dept Clin Pharmacol,Drug InformatUnit, Kathmandu, Nepal Tribhuvan Univ Kathmandu Nepal acol,Drug InformatUnit, Kathmandu, Nepal
Titolo Testata:
TROPICAL MEDICINE & INTERNATIONAL HEALTH
fascicolo: 11, volume: 4, anno: 1999,
pagine: 782 - 788
SICI:
1360-2276(199911)4:11<782:ADBDRI>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY-TRACT INFECTIONS; URBAN BRAZILIAN SLUM; GIARDIA-LAMBLIA; ANTIMICROBIAL RESISTANCE; INTERCONTINENTAL SPREAD; DEVELOPING-COUNTRIES; CHILDREN; DIARRHEA; MANAGEMENT; PATTERNS;
Keywords:
antibiotics; developing country; drug use; Nepal; pharmacies; pharmacoepidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Wachter, DA Univ New Mexico, Sch Med, Dept Emergency Med, Ambulatory Care Ctr W 4, 2211 Lomas Blvd NE, Albuquerque, NM 87131 USA Univ New Mexico 2211Lomas Blvd NE Albuquerque NM USA 87131 SA
Citazione:
D.A. Wachter et al., "Antibiotic dispensing by drug retailers in Kathmandu, Nepal", TR MED I H, 4(11), 1999, pp. 782-788

Abstract

OBJECTIVES To assess over-the-counter antimicrobial dispensing by drug retailers in Kathmandu, Nepal, for rationality, safety, and compliance with existing government regulations. METHODS Standardized cases of dysuria in a young adult male and acute watery diarrhoea in a child were presented by a mock patient to retailers at 100 randomly selected pharmacies. Questions asked by retailers and advice andmedications given at their initiative were recorded. RESULTS All retailers engaged in diagnostic and therapeutic behaviour beyond their scope of training or legal mandate. Historical information obtained by retailers was inadequate to determine the nature or severity of disease or appropriateness of antimicrobial therapy. 97% (95% CI = 91.5-99.4%) ofretailers dispensed unnecessary antimicrobials in diarrhoea, while only 44% (95% CI = 34.1-54.3%) recommended oral rehydration therapy and only 3% (95% CI = 0.6-8.5%) suggested evaluation by a physician. 38% (95% CI = 28.5-48.2%) gave antimicrobials in dysuria, yet only 4% (95% CI = 1.1-9.9%) adequately covered cystitis. None covered upper urinary tract or sexually transmitted infections, conditions which could not be ruled out based on the interviews, and only 7% (95% CI = 2.9-13.9%) referred for a medical history andphysical examination necessary to guide therapy. CONCLUSIONS Although legislation in Nepal mandates a medical prescription for purchase of antibiotics, unauthorized dispensing is clearly problematic. Drug retailers in our study did not demonstrate adequate understanding ofthe disease processes in question to justify their use of these drugs. Risks of such indiscretion include harm to individual patients as well as spread of antimicrobial resistance. More intensive efforts to educate drug retailers on their role in dispensing, along with increased enforcement of existing regulations, must be pursued.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 16:06:01