Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties

Melander, Eva; Nissen, Aase; Henricson, Karin; Merlo, Juan; Mölstad, Sigvard; Kampmann, Jens P.; Lithman, Thor; Hansen, Ebba Holme; Melander, Arne

doi:10.1007/s00228-003-0624-0

Cited by 19 publications

(12 citation statements)

References 22 publications

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“…Melander et al noted that there is a higher prevalence of infectious diseases in children. As a result, higher numbers of anti-infectives are used in this group than any other class of drugs [24]. …”

Section: Discussionmentioning

confidence: 99%

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

2017

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Background Although medications play a vital role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems (DRPs). DRPs are common in hospitalized patients. Specifically, pediatrics population are easily affected by DRPs, as dynamic and kinetic behaviors of drugs in this population are usually different than in adults. Objectives To assess the prevalence of DRPs and associated factors in a pediatric setting in Ethiopia. Setting Pediatric ward of Zewditu Memorial Referral Hospital, Addis Abbeba, Ethiopia. Methods A cross-sectional study was conducted on 285 randomly selected patients. Data were obtained through review of physician medication orders and patient files. The prevalence and type of DRPs were studied and documented using the Pharmaceutical Care Network Europe Foundation classification system. The results were summarized using descriptive statistics including frequency, mean, and standard deviation. To identify the independent predicators of DRPs, logistic regression analysis was run and a P value ≤0.05 was considered as statistically significant. Main outcome measure DRPs, types of DRPs, drugs that are frequently involved in DRPs, and factors associated with DRPs. Main outcome measure Number of DRPs. Results Of the 1055 medication orders reviewed, a total of 106 DRPs were identified in 90 patients. This gives an overall rate of drug-related problems of 31.57%. The most frequently identified DRPs were dosing problems, with dose too low being 34.9% and dose too high being 7.5%. This was followed by drug–drug interactions(38.67%) and adverse drug reactions (8.49%). The number of prescribed drugs (AOR 2.3, 95% CI 1.3–4.3, P = 0.007) and total number of disease conditions (AOR4.8, 95% CI 1.9, 12.1, P = 0.001) were potential risk factors for occurrence of DRPs. Conclusion The present study demonstrated that DRPs were common at the pediatric ward of Zewditu Memorial Referral Hospital and that it needs great attention. The most frequently identified DRPs were dosing problems, followed by drug–drug interactions and adverse drug reaction. Poly-pharmacy and number of disease conditions have been identified as important risk factors for occurrence of DRPs. The investigators recommend establishing a system for reporting DRPs in the pediatric ward of the hospital as it may facilitate appropriate measures for prospective interventions, such as training the healthcare team, as well as detail precautions to be followed by the practitioners. In addition to this, improving communication between the healthcare team members such as physicians, pharmacists, nurses, and other healthcare workers in the hospital is recommended.

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Section: Discussionmentioning

confidence: 99%

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

2017

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“…44 However, the current study found that increased deprivation in the education, skills, and training domain of the IMD-2004 had a stronger association with high antibiotic prescribing than deprivation in other domains, although European studies have shown that this association varies according to geographical location. 45,46 Implications and further study Several countries have undertaken national campaigns to reduce inappropriate antibiotic prescribing. 2 The present findings suggest that if further campaigns are to reach practices that are high antibiotic prescribers, it may be useful to focus on practices in the north of England, non-training practices, and practices with higher proportions of male GPs, GPs aged >45 years, and non-UKqualified GPs.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Which practices are high antibiotic prescribers? A cross-sectional analysis

et al. 2009

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Substantial variation in antibiotic prescribing rates between general practices persists, but remains unexplained at national level. AimTo establish the degree of variation in antibiotic prescribing between practices in England and identify the characteristics of practices that prescribe higher volumes of antibiotics. Design of studyCross-sectional study. Setting general practices in England. MethodA dataset was constructed containing data on standardised antibiotic prescribing volumes, practice characteristics, patient morbidity, ethnicity, social deprivation, and Quality and Outcomes Framework achievement (2004)(2005). Data were analysed using multiple regression modelling. ResultsThere was a twofold difference in standardised antibiotic prescribing volumes between practices in the 10th and 90th centiles of the sample (0.48 versus 0.95 antibiotic prescriptions per antibiotic STAR-PU [Specific Therapeutic group Age-sex weightingsRelated Prescribing Unit]). A regression model containing nine variables explained 17.2% of the variance in antibiotic prescribing. Practice location in the north of England was the strongest predictor of high antibiotic prescribing. Practices serving populations with greater morbidity and a higher proportion of white patients prescribed more antibiotics, as did practices with shorter appointments, non-training practices, and practices with higher proportions of GPs who were male, >45 years of age, and qualified outside the UK. ConclusionPractice and practice population characteristics explained about one-sixth of the variation in antibiotic prescribing nationally. Consultation-level and qualitative studies are needed to help further explain these findings and improve our understanding of this variation.

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“…A few studies have demonstrated that children's medicine use patterns vary across age groups. Antibiotics are primarily prescribed to young children [4,5], while use of medicine for aches is common among adolescents and is seen to increase with their age [6,7]. However, a couple of studies, based on reports from parents or health care personnel, have indicated that the mere act of taking medicines may be troublesome to children, primarily due to the medications' taste [8,9] and problems with swallowing tablets [9].…”

Section: Introductionmentioning

confidence: 99%

Adolescents’ struggles with swallowing tablets: barriers, strategies and learning

2007

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Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties

Cited by 19 publications

References 22 publications

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

Which practices are high antibiotic prescribers? A cross-sectional analysis

Adolescents’ struggles with swallowing tablets: barriers, strategies and learning

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