Adherence to an antibiotic policy and sensitivity testing recommended for rational antibiotic prescribing in a tertiary care institute in Trinidad - Poster abstract

OBJECTIVE: To determine the use of antimicrobials in inpatients at the Eric Williams Medical Sciences Complex (EWMSC), Trinidad. DESIGN AND METHODS: Adult and paediatric patients admitted to the general medical and surgical wards for at least 1 week and receiving antibiotics for at least 3 consecutive days during the period January 1 to March 15, 1999 were eligible for study. Patient data collected included demography, concomitant therapy and length of stay. The details of dosing and relevant clinical history were noted from treatment charts and from interviews of the physicians where indicated. RESULTS: Of 967 patients who were admitted to the hospital during the study period, 83 were eligible for the study. Of the 158 courses of antibiotics that were prescribed, 81 (51.3 percent were for therapeutic intervention and 77 ( 48.7 percent) were for prophylaxis. Sixty-five percent (65 percent) of courses were combination therapy and only only 35 percent involved a single agent. The á-lactams were the most frequently prescribed class of antimicrobial drugs (70.3 percent). None of the 11 resident doctors who were interviewed knew of the hospital's antibiotic policy. CONCLUSIONS: Antimicrobial prescribing was nearly always empirical, the hospital's antibiotic policy was not adhered to and the laboratory was not used as a tool to facilitate antimicrobial prescribing. The Pharmacy Services at the institution should play a more active role in monitoring compliance with the hospital's Antibiotic Policy.(Au)

The drug regulatory and review process in Guyana

After the old "Sale of Food and Drugs" Ordinance, Cap. 144 was repealed, the new Food and Drugs Act was enacted in 1971. This new act has considerable flexibility and gives the Minister extensive authority to make Regulations (for carrying out the purposes and provisions of the Act). The Act controls the manufacture, importation, sale, advertising, labeling, packaging, and distribution of drug samples, and the testing of drugs. The Act also controls raw materials and finished products of drugs at the point of entry into the country, with a single agency coordinating both the inspection and analytical services. Developing countries could ensure the procurement of safe, good quality, and effective drugs and devices with the enactment of a similar Food and Drugs Act only. Rapid assessment of Drug Safety, Quality and Efficacy is done through Guyana's participation in the WHO Certification Scheme on the Quality of Pharmaceutical Products moving in International Commerce. This certification scheme is highly commendable especially to third-world countries. The Food and Drug Regulations (1977) have several unique features for drug, cosmetic and device control and they allow for a system of centralized control with limited staff to enforce the legislation. In summary, enforcement of legislative control of imported pharmaceuticals and product evaluation can be considered strong points in the drug regulatory and review process in Guyana. A cautious attitude is observed so as to ensure efficacy, safety, and quality of drugs entering the market. This Drug Regulatory and Review Process is recommended for implementation by third-world countries with outdated drug legislation. (AU)

Co-ordinated countermeasures of Caribbean countries against the illicit drug traffic: recent developments and prospects

The illicit traffic in narcotic drugs and psychotropic substances presents a growing threat to the Caribbean countries and territories. The geographical location of the Caribbean subregion between the areas in South America producing illicit drugs and lucrative illicit markets in North America and Europe is an important factor contributing to an increasing involvement of the subregion in illicit drug trafficking operations. In addition, the archipelagic configuration of many of the countries and territories of the Caribbean makes it easier for traffickers to escape law enforcement action, thus providing a further stimulus to international drug trafficking. The Caribbean Governments have therefore initiated law enforcement countermeasures to combat drug trafficking and taken legal and administrative action to prevent and eradicate illicit cultivation of narcotic crops, as well as to prevent and reduce illicit demand for drugs. The Government have also made increasing efforts to improve international and bilateral co-operation to combat drug trafficking and drug abuse. The decisive efforts of Caribbean Governments, however, are impeded, on the one hand, by the limited availability of trained professional manpower and of the technical and economic resources required to combat drug trafficking effectively, and, on the other hand, by the superior financial and technical capacity of the international drug trafficking organizations. The provision of technical and financial assistance by the international community to the countries and territories of the Caribbean is therfore needed to help overcome these constraints and to enable them to cope with the increasing drug problems in the subregion.(AU)

The regulatory situation in Trinidad and Tobago for trade in herbal medicinal products

The Chemistry/Food and Drugs Division, Ministry of Health is the government's monitoring and regulatory authority for the control, manufacture, importation, storage and disposal of food, drugs (pharmaceuticals), cosmetics, medical devices, pesticides and toxic chemicals. The Division is mandated to ensure that only safe and quality food, drugs, cosmetics and medical devices of an acceptable standard reach the consumers. The Division is also responsible for ensuring safety in use, proper management and acceptable standards for pesticides and toxic chemicals and providing technological and laboratory services in the areas of food, drugs, cosmetics, medical devices, pesticides and toxic chemicals. Through a system of inspection, registration, licensing and laboratory work the regulatory functions are achieved. Herbal products, including herbal food supplements, traditional herbal remedies and herbal medicines, which are offered for sale in Trinidad and Tobago clearly fall under the jurisdiction of the Chemistry/Food and Drugs Division (AU)