Errors in Antibiotic Therapy: Study with Dentist's Prescriptions in a Large Brazilian City

Objective: To evaluate errors in dental prescriptions of antibiotics for therapeutic purpose. Material and Methods: This was a descriptive study using a random and calculated sample of 366 prescriptions (July1 2011 to June 30 2012), from a total of 31 105 dental prescriptions, was surveyed in an important drugstore chain in a large Brazilian city. Data was validated by double entry in Epi-data (EpiData Assoc, Odense M, Denmark) and then analysed in SPSS (version 19.0, Chicago, IL, USA). Statistical analyses included the calculation of proportions with a 95% confidence interval (CI). Results: We identified 272 prescriptions for therapeutic purpose. Prescription errors involved spelling of the antibiotic name, dose, dosing intervals and duration of treatment. A total of 116 prescriptions (42.6%; 95% CI 36.9%-48.6%) were considered to be totally correct with regard to the generic name, dose, dosing interval and duration of the antibiotic therapy. Most of the antibiotics prescribed by dentists showed errors related to the name, dose, intervals and duration of treatment. Conclusion: These errors may compromise the effectiveness of drug therapy, contribute to microbial resistance and increase the risk of adverse events and costs of treatment.

Legal Aspects of Dental Antibiotic Prescriptions: ADescriptive Study in a Large Brazilian City

Objective:To quantify the antimicrobial drugs most commonly prescribed by dentists since the institution of legal controls in Brazil and to identify the presence of errors in the legal requirements of some of these drugs. Materials and Methods:This is a cross-sectional study of dental antibiotic prescriptions at 69 drug stores in a chain of pharmacies in Belo Horizonte, Brazil. A calculated sample of dental antimicrobial drug prescriptions was selected using simple random sampling from a total of 31,105 prescriptions.The following data were analyzed: the type of antimicrobial drug; the presence of a prescription in accordance with the Common Brazilian Nomenclature (DCB); the name, gender, age and address of the patient; the name, signature, address, telephone number, Regional Dental Council registration number and stamp of the prescriber. After double entry in the Epi-Data program, a descriptive analysis was performed using SPSS version 19.0. Results:A total of 366 dental antimicrobial drug prescriptions were analyzed. The majority of the antimicrobial drugs prescribed were from the penicillin group (71.9%; CI95% 67.0-76.2), 99.7% of which were amoxicillin with or without clavulanic acid. The second most commonly prescribed drugs were the macrolides (16.7%; CI95% 13.2-20.8). The majority (92.8%) had 3 to 5 errors. The most frequent errors were as follows: spelling of the drug name not in accordance with the DCB (72.1%), and the absence of patient information such as age (99.7%), gender (99.8%), and address (87.0%). Conclusion:Antimicrobial drugs of the penicillin and macrolide groups were prescribed most often by dentists, and the majority of those prescriptions had three to five errors, with spelling of the drug name not in accordance with the DCB and missing patient information as the most common errors

Prescribing errors in antibiotic prophylaxis by dentists in a large Brazilian city.

Prescribing errors may contribute to antibiotic resistance and other drug-related problems. To investigate the quality of prescriptions involving antibiotic prophylaxis by dentists in a large Brazilian city, 366 dental prescriptions were randomly selected from 31,105. A prophylaxis indication represented 24.9% of the prescriptions, and only 12 (13.2%; 95% confidence interval, 7.7%-21.7%) were correct regarding the generic name, dose, and length of antibiotic use. Prescriptions for antibiotic prophylaxis by dentists are mostly inadequate in this city.

Receitas médicas e dispensação farmacêutica: uma questão de saúde / Medical prescriptions and pharmaceutical dispensing: a health matter

Analisar criticamente receitas médicas do ponto de vista da dispensação farmacêutica. Método. Atendendo critérios de conveniência, pelo sistema de amostragem aleatória simples, foram coletadas cópias de 311 receitas médicas, contendo medicamentos não manipulados e dispensadas em duas farmácias de grande porte do município de Belo Horizonte/MG. Além do número de medicamentos prescritos, foi verificada a presença dos seguintes itens: identificação do prescritor e do paciente, esquema posológico, dose, duração do tratamento e orientação quanto ao modo de usar. Resultados: Das receitas analisadas, cerca de 43% prescreviam mais de um medicamento. Observou-se a ausência de dados de identificação do prescritor, como o nome e/ou número de registro no Conselho Profissional, e até a omissão de assinatura. Quanto aos dados do paciente, todas continham o nome e todas omitiam o endereço. Estavam ausentes ainda, em uma parcela expressiva de receitas, O esquema posológico, o modo de uso do medicamento e a duração do tratamento. Conclusões: A maioria das receitas analisadas apresentava problemas que poderiam comprometer a eficácia da terapêutica, por omissão da dose, do modo de uso e da duração do tratamento. O fato de terem sido dispensadas aponta no sentido de que os responsáveis pela dispensação estariam desenvolvendo papel meramente comercial.

To elaborate a critical evaluation of medical prescriptions from the point of view of the pharmaceutical dispensing. Method: A total of 311 medical prescriptions at two major pharmacies in Belo Horizonte, MG, were collected. The medical prescriptions were analyzed and identification of the physician and the patient, the number of prescribed medicines, indications of dosage and administration, treatment duration and instructions about their use were determined. Results: A total of 43% of the prescriptions contained more than one medicine. In many prescriptions, the physician was not identified. Some prescriptions did not present the name of the physician or the registration number in Conselho Regional de Medicina (CRM). Prescriptions without the signature of the physician were also found. All the prescriptions did not include the patient address. Indications of dosage and administration, instructions about the use and duration of the treatment were also absent in many prescriptions. Conclusions: According to the specific legislation, none of the analyzed prescriptions could have been dispensed as all of them did not present the patient address. Most of them presented problems that could reduce the therapeutic efficacy, such as omissions of dosage and administration, instructions about the use and duration of the treatment. The realisation that all the analysed prescriptions were dispensed in spite of the mentioned problems indicates that the professionals controlling the act of dispensing would be merely exerting a commercial role.

Associações em doses fixas entre antibióticos e antiinflamatórios enzimáticos são realmente necessárias em Odontologia? / Associations of enzimatic antiinflammatories and antibiotics in fix doses are necessary in dentistry?

As autoras realizam uma breve revisão da literatura sobre as controvérsias a respeito do emprego dos antiinflamatórios enzimáticos por via oral e da sua associação em doses fixas com antimicrobianos. A luz do relatório final realizado pelo Grupo de Estudos em Medicamentos Antimicrobianos (GEMA), a respeito das associações em doses fixas contendo antimicrobianos, esclarecem porque o cirurgião-dentista deve preferir a utilização de cada medicamento em separado

Avaliaçäo farmacológica preliminar do extrato liofilizado de angico (Piptadenia colubrina Bth) / Preliminary pharmacologic evaluation of freeze-dried extract of angico (Piptadenia colubrina Bth)

Cascas de angico (Piptadenia colubrina Bth) foram coletadas na regiäo do Alto Paranaiba/Minas Gerais e submetidas a processos de extraçäo e liofilizaçäo. O extrato foi empregado em testes farmacológicos com camundongos e ratos machos albinos. Observou-se que doses variáveis do extrato provocaram sinais de depressäo do sistema nervoso central e insuficiência respiratória. Observou-se também que o extrato acarretou um efeito sinérgico quando associado a doses sub-hipnóticas de pentobarbital sódico e a doses sedativas de clorpromazina e diazepam. Embora a informaçäo popular se refira a propriedades antiepilépticas do "chá de angico", os resultados näo demonstraram açäo anticonvulsivante em relaçäo ao pentetrazol. Além do mais, observou-se que o extrato näo possui açäo analgésica e nem altera a açäo analgésica do cloridrato de morfina. Os resultados obtidos sugerem propriedades psicotrópicas do tipo psicoléptico (depressoras do sistema nervoso central) para o material estudado.

Possíveis alteraçöes fisiológicas induzidas pelo estresse em ratos / Some physiological changes induced by stress in rats

Os autores submeteram ratos albinos machos a estresse crônico - choque nas patas associado ao som de uma campainha - durante sete a trinta dias. Estudaram a influência deste tipo de estresse sobre a atividade motora, o ganho de peso e a integridade da mucosa gástrica. Observaram que este tipo de estresse exerce açäo depressora ou inibidora da motilidade dos ratos, ao passo que näo interfere com o ganho de peso e näo é capaz de levar ao desenvolvimento de úlceras ou lesöes gástricas.