RESUMEN
This study aimed at measuring the medico-economic interest of a care management programme established for asthmatic patients in the Amiens region ("Action Asthma Amieris") by using and comparing different evaluation tools. Three tools were used in parallel: 1) a questionnaire for collecting information on healthcare received was completed monthly by 305 patients recruited by 73 physicians between November 1998 and January 1999; 2) data issued by the national insurance fund for the years 1998 and 1999, for those patients included after January 1999; and 3) data on all hospitalisations for 1998 and 1999 in the University Hospital Centre obtained from the French hospital information database (PMSI). Data from the national insurance fund and from the PMSI are essential to evaluate costs, since the patients' statements proved to under-estimate the amount of healthcare administered and received. Following the implementation of this asthma care management programme, an increase of pharmaceutical expenses and a decrease in the number of hospitalisations for asthmatic patients were observed.
Asunto(s)
Asma/economía , Asma/terapia , Manejo de la Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Encuestas de Atención de la Salud , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana EdadRESUMEN
The in vitro activity of meropenem, a new carbapenem, and the combination effect with netilmicin, tobramycin, gentamicin, and teicoplanin against Pseudomonas spp. and enterococci was studied. Meropenem showed very good in vitro activity against Pseudomonas aeruginosa (MIC90 2 mg/l) and good to moderate activity against Pseudomonas putida (MIC90 4 mg/l) and Enterococcus faecalis (MIC90 8 mg/l). Aminoglycosides were highly active against P. putida (MIC90 0.5 mg/l), but showed only moderate activity against P. aeruginosa. The synergistic effect of meropenem was shown in combination with teicoplanin against E. faecalis (40%). No Pseudomonas strains were inhibited by the synergistic effect of meropenem with aminoglycosides. No antagonism occurred with any of the combinations.
Asunto(s)
Infección Hospitalaria/tratamiento farmacológico , Quimioterapia Combinada/uso terapéutico , Enterococcus faecalis , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Pseudomonas/tratamiento farmacológico , Aminoglicósidos , Antibacterianos/uso terapéutico , Infección Hospitalaria/microbiología , Evaluación Preclínica de Medicamentos , Sinergismo Farmacológico , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Meropenem , Pruebas de Sensibilidad Microbiana , Infecciones por Pseudomonas/microbiología , Teicoplanina/uso terapéutico , Tienamicinas/uso terapéuticoRESUMEN
In a quantitative in vitro model the activity of vancomycin and teicoplanin in two concentrations (4 x MBC and 1 mg/l) against Staphylococcus aureus and a slime-producing Staphylococcus epidermidis strain colonizing the internal surface of polyurethane and silicone catheters was studied. In comparison with vancomycin, teicoplanin achieved a significantly greater reduction (p < 0.05) in the counts of Staphylococcus aureus and Staphylococcus epidermidis adhering to both polyurethane and silicone catheters.