Oral Rehydration Therapy for Low Birth Weight Neonates Suffering from Diarrhea in the Intensive Care Unit

N, Helmy; Abdalla, Safia; M, el Essaily; Nasser, Shafika; Hirschhorn, Norbert

doi:10.1097/00005176-198805000-00018

Cited by 5 publications

(1 citation statement)

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“…Only 44% of retailers recommended any form of hydration therapy, widely recognized as the most important morbidity and mortality‐reducing intervention in diarrhoeal disease ( Helmy et al . 1988 ; WHO 1988; Claeson & Merson 1990; WHO 1995; Gove 1997).…”

Section: Discussionmentioning

confidence: 99%

Antibiotic dispensing by drug retailers in Kathmandu, Nepal

Wachter

Joshi

Rimal

1999

Tropical Med Int Health

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Summaryobjectives 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 and medications 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 ϭ 91.5-99.4%) of retailers dispensed unnecessary antimicrobials in diarrhoea, while only 44% (95% CI ϭ 34.1-54.3%) recommended oral rehydration therapy and only 3% (95% CI ϭ 0.6-8.5%) suggested evaluation by a physician. 38% (95% CI ϭ 28.5-48.2%) gave antimicrobials in dysuria, yet only 4% (95% CI ϭ 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 ϭ 2.9-13.9%) referred for a medical history and physical 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 of the 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.

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Section: Discussionmentioning

confidence: 99%