Background With the Ministry of Health's projected increase in nursing home beds and optimization of antimicrobial use in health care settings, it is therefore timely to consider baseline prevalence and patterns of antimicrobial use at nursing homes in Singapore as well as to evaluate the prevalence of potential clinically significant drug-drug interactions involving antimicrobials. Objective The primary objective was to determine the prevalence and patterns of antimicrobial use at nursing homes in Singapore. The secondary objective was to evaluate the prevalence of potential clinically significant drug-drug interactions involving antimicrobials. Setting Four nursing homes in Singapore. Method A retrospective cross-sectional study was conducted among nursing home residents. The antimicrobial prevalence, defined daily doses, days of therapy, and potential drug-drug interactions were determined using data from archived resident medication prescribing and administration records. Main outcome measure Prevalence and patterns of antimicrobial use, drug-drug interactions involving antimicrobials. Results Among 707 residents (mean age: 80.7 ± 8.8 years, female: 57.1%), 10% used antimicrobials during the study month, with a 1-day point prevalence of 3%. The utilization rates of antimicrobials were 28.9 defined daily doses/1000 resident-days and 24.8 days of therapy/1000 resident-days. Potential drug-drug interactions involving antimicrobials were identified among 32 of the 70 (46%) residents who were prescribed antimicrobials. Of these, 26 (81%) residents had 43 potential clinically significant drug-drug interactions. Conclusions The prevalence and utilization rates of antimicrobial use in Singapore nursing homes appear to be low. Yet, potential clinically significant drug-drug interactions are prevalent.
Facilitators of best practices• The ability to reach and invite all community pharmacists into the practice enabled us to reach patients from different regions. • Obtaining workforce and financial sources from a wellestablished pharmacy association enabled rapid problem solving during the implementation phase.
Education is one of the areas affected by COVID-19. The authorities in Turkey responded fast to COVID-19 with the continuation of distance learning in higher education after 13 days of the first case. It was the first time pharmacy schools provided distance learning in Turkey. Although, in the beginning, there were some problems, students and academic staff adopted an online platform in a few weeks. Surveys completed by students and academic staff demonstrated that distance learning could provide opportunities for students such as easy access to lecture notes and repetition of lectures, and for academic staff improved working environment, flexibility and time-saving. However, both students and academic staff do not agree that face-to-face education should be replaced with distance learning. Using online platforms for distance learning in response to COVID-19 has enlightened faculty in terms of adopting new technology and educational techniques in lectures.
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