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1.
Lancet ; 398(10307): 1230-1238, 2021 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-34599878

RESUMEN

BACKGROUND: Over the course of the COVID-19 pandemic, the care of patients with COVID-19 has changed and the use of extracorporeal membrane oxygenation (ECMO) has increased. We aimed to examine patient selection, treatments, outcomes, and ECMO centre characteristics over the course of the pandemic to date. METHODS: We retrospectively analysed the Extracorporeal Life Support Organization Registry and COVID-19 Addendum to compare three groups of ECMO-supported patients with COVID-19 (aged ≥16 years). At early-adopting centres-ie, those using ECMO support for COVID-19 throughout 2020-we compared patients who started ECMO on or before May 1, 2020 (group A1), and between May 2 and Dec 31, 2020 (group A2). Late-adopting centres were those that provided ECMO for COVID-19 only after May 1, 2020 (group B). The primary outcome was in-hospital mortality in a time-to-event analysis assessed 90 days after ECMO initiation. A Cox proportional hazards model was fit to compare the patient and centre-level adjusted relative risk of mortality among the groups. FINDINGS: In 2020, 4812 patients with COVID-19 received ECMO across 349 centres within 41 countries. For early-adopting centres, the cumulative incidence of in-hospital mortality 90 days after ECMO initiation was 36·9% (95% CI 34·1-39·7) in patients who started ECMO on or before May 1 (group A1) versus 51·9% (50·0-53·8) after May 1 (group A2); at late-adopting centres (group B), it was 58·9% (55·4-62·3). Relative to patients in group A2, group A1 patients had a lower adjusted relative risk of in-hospital mortality 90 days after ECMO (hazard ratio 0·82 [0·70-0·96]), whereas group B patients had a higher adjusted relative risk (1·42 [1·17-1·73]). INTERPRETATION: Mortality after ECMO for patients with COVID-19 worsened during 2020. These findings inform the role of ECMO in COVID-19 for patients, clinicians, and policy makers. FUNDING: None.


Asunto(s)
COVID-19/terapia , Oxigenación por Membrana Extracorpórea/métodos , Mortalidad Hospitalaria/tendencias , Síndrome de Dificultad Respiratoria/terapia , Adulto , COVID-19/mortalidad , Duración de la Terapia , Oxigenación por Membrana Extracorpórea/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Guías de Práctica Clínica como Asunto , Sistema de Registros , Síndrome de Dificultad Respiratoria/mortalidad , SARS-CoV-2
2.
Rev Med Liege ; 76(10): 761-767, 2021 Oct.
Artículo en Francés | MEDLINE | ID: mdl-34632747

RESUMEN

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental trouble characterized by deficits in communication and social interactions associated with restricted and repetitive behaviour, interests and activities. Given the heterogeneity of the disorder and the absence of biomarker, its diagnostic approach must be comprehensive and multidisciplinary, according to international classifications. The aetiology of ASDs remains mostly unknown and results from a multifactorial model. This document offers guidelines to standardize practices and optimize the exploration of children with autism.


Asunto(s)
Trastorno del Espectro Autista , Trastorno del Espectro Autista/diagnóstico , Niño , Comunicación , Familia , Humanos
3.
An Pediatr (Engl Ed) ; 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34642127

RESUMEN

The management of Helicobacter pylori infection in children is a consistent problem in clinical practice. Over the years, many questions have been raised regarding symptoms associated with the infection, the diagnostic methods and type of treatment. What is most controversial is determining the criteria that enable us to initiate and carry out the study in children. In the last 10 years, pediatricians have followed the joint ESPGHAN/NASPGHAN guidelines published in 2011 and updated in 2017 in the management of H. pylori in children. This document aims to unify the study indication criteria as well as the diagnosis and treatment recommendations for H. pylori infection in children and adolescents, so they can be used in both Primary and Hospital care.

4.
J Emerg Nurs ; 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34627610
5.
Nurs Outlook ; 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34627615

RESUMEN

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.

6.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34629204

RESUMEN

Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.

7.
Eur Urol Focus ; 2021 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-34598912

RESUMEN

The importance of patient involvement in guideline development is internationally recognised, yet there is a lack of clear methodology for integrating patient preferences and values in guidelines and a need to identify the optimum stages for involving patients in guideline production. European Association of Urology (EAU) guidelines have international reach, a rigorous guideline production process, an established patient information section, and existing links with European cancer patient organisations. This makes the EAU the ideal setting to test a framework for patient involvement in guideline development for genitourinary cancers. The EVOLVE study is a unique collaboration involving a professional society, guideline panels, researchers, clinicians, and patient organisations with the aim of designing a framework for meaningful patient involvement in guideline production. Stages for considering patient preferences and values were identified via systematic review and interviews with key stakeholders, then prioritised by patients and clinicians via an international Delphi study. The final EVOLVE framework will be tested within EAU guideline panels and a strategy to assess the impact of patient involvement in guidelines will be developed. PATIENT SUMMARY: There is increasing awareness of the need to include patient values and preferences when developing guidelines for medical practice. The EVOLVE study is designing a framework for patient involvement in guideline development. TAKE HOME MESSAGE: A framework for meaningful patient involvement in guideline development and implementation has been developed. The EVOLVE framework can help guideline developers to involve patients at the optimum stages of guideline production, which may improve the quality and relevance of guidelines.

8.
Rev Clin Esp (Barc) ; 2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34620581

RESUMEN

BACKGROUND: The purpose of this study was to learn about the clinical practice of specialists who care for patients with giant cell arteritis, to verify whether they follow the diagnosis and treatment recommendations for this disease, and to identify areas for improvement. METHODS: A cross-sectional survey on clinical practice in 2019. The survey was completed by 167 physicians (64% rheumatologists, 27% internal medicine specialists, and 9% other specialists) who attended a course on updating giant cell arteritis treatment. We compared the clinical practice collected in the study with the latest recommendations approved by the European League Against Rheumatism (EULAR). RESULTS: The physicians surveyed cared for a median of 10 patients (interquartile range 6-30) with giant cell arteritis during their practice. As a diagnostic method, respondents used temporal artery biopsy (84%), temporal artery ultrasound (61%) or other imaging techniques (37%). As first-line therapy, respondents used high-dose glucocorticoids (at least 40 mg of prednisone, or equivalent, per day) (84%), glucocorticoids with methotrexate (7%) and glucocorticoids with tocilizumab (5%). The most frequent drugs used for relapse were methotrexate (37%) and tocilizumab (58%). CONCLUSION: Our results indicate that the medical specialists surveyed follow the recent EULAR recommendations for giant cell arteritis diagnosis and therapy.

9.
Rev Esp Salud Publica ; 952021 Oct 01.
Artículo en Español | MEDLINE | ID: mdl-34593751

RESUMEN

The objective of this work was to describe the implantation project presented by the Virgen de las Nieves University Hospital (Granada, Spain) to be selected as a candidate for "Best Practice Spotlight Organization"® (in Spain CCEC®) program in the cohort (2015-2017) to implement three guidelines for Nurses Association of Canada Ontario (RNAO) clinical practice of care. The methodology used was the model called "knowledge for action" and the actions developed for each of the phases of the action cycle for applying knowledge to practice were described: 1) identification of the problem, 2) adaptation to the local context, 3) evaluation of facilitators and barriers, 4) adaptation and implementation of interventions, 5) monitoring and evaluation of results and 6) sustainability. This work adds to the set of studies that address the improvement and maintenance of evidence-based practice programs in nursing, and in health services in general. It shows the application of a framework for the implementation of clinical practice guidelines for care in a specific health environment for its replication in other different health settings. It has been shown that it is essential to dedicate efforts to planning the implementation of this type of programs, taking into account the context in which they are developed, the specific characteristics of the population being served, identifying the different barriers and facilitators that may affect during the course of the program. process and defining actions to make the changes in practice sustainable.


Asunto(s)
Medicina Basada en la Evidencia , Hospitales Universitarios , Desarrollo de Programa , Medicina Basada en la Evidencia/organización & administración , Hospitales Universitarios/organización & administración , Humanos , España
10.
Int Marit Health ; 72(3): 223-227, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34604993

RESUMEN

Since the global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of a coronavirus disease 2019 (COVID-19) infection started, millions of people globally have become infected. It must not be forgotten that thousands of those affected are commercial or recreational divers. A severe COVID-19 seriously affects the respiratory system and the pulmonary parenchyma but it may also involve the cardiovascular and the blood coagulation system. For this reason, many divers and hyperbaric medicine specialists are becoming increasingly concerned about a diver's ability to safely return to diving after a SARS-CoV-2 infection. The article presents current guidelines for diving fitness health assessment after a COVID-19 both for active and prospective divers, with particular emphasis on the types of diagnostic procedures and tests to be performed in cases of asymptomatic infection with SARS-CoV-2 as well as in patients who have recovered from a symptomatic COVID-19.


Asunto(s)
COVID-19/complicaciones , Buceo/normas , Reinserción al Trabajo , Guías como Asunto , Humanos , SARS-CoV-2
11.
Medicina (B Aires) ; 81(5): 786-790, 2021.
Artículo en Español | MEDLINE | ID: mdl-34633953

RESUMEN

Renal cancer represents 3-4% of all malignancies. Its incidental detection is becoming more frequent. Surgery is the gold standard treatment for T1 renal cancer. Still, surgery is not suitable for every patient due to comorbidities or previous kidney surgery. Guidelines provided by The American Urological Association recommend thermoablation therapies as an alternative to surgery in tumors under 3 cm. Experience regarding percutaneous cryoablation in renal tumors is scarce in Latin America and there are only a handful of publications in this region regarding this subject. The objective of this study was to assess the effectiveness and security of percutaneous cryoablation in a cohort of adult patients with cT1 renal cancer (smaller than 5 cm) as an alternative to surgery. The procedures were performed with CT or Cone Beam CT guidance and under general anesthesia in sterile conditions. Cryoablation was carried out on an outpatient basis. Follow up was done with imaging studies, blood test and clinical consultation. All patients had complete response in imaging studies. There were no complications in 61% of all of them, the remaining patients suffered grade-1 complications such as hematuria, urinary retention and perirenal hematoma. In conclusion, percutaneous cryoablation for renal tumors is a safe and effective alternative to surgery.


Asunto(s)
Criocirugia , Neoplasias Renales , Adulto , Humanos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/cirugía
12.
Medicina (B Aires) ; 81(5): 817-836, 2021.
Artículo en Español | MEDLINE | ID: mdl-34633957

RESUMEN

Guillain-Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and in 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.


Asunto(s)
Síndrome de Guillain-Barré , Infección por el Virus Zika , Virus Zika , Brotes de Enfermedades , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/epidemiología , Síndrome de Guillain-Barré/terapia , Humanos , Incidencia , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/terapia
13.
Nurs Womens Health ; 25(5): 329-336, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34602165

RESUMEN

OBJECTIVE: To solicit advice from members of the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) on what to include in an update of nurse staffing standards. DESIGN: Online, single-question survey with thematic analysis of responses. SETTING: Electronic survey link sent via e-mail. PARTICIPANTS: AWHONN members who shared their e-mail with the association and who responded to the survey (n = 1,813). MEASURES: Participants were asked to answer this single question: "The AWHONN (2010) Guidelines for Professional Registered Nurse Staffing for Perinatal Units are being updated. During their initial development, feedback from nearly 900 AWHONN members was extremely helpful in providing specific details for the nurse staffing guidelines. We'd really like to hear from you again. Please give the writing team your input. What should AWHONN consider when updating the AWHONN nurse staffing guidelines?" RESULTS: The e-mail was successfully delivered to 20,463 members; 8,050 opened the e-mail, and 3,050 opened the link to the survey. There were 1,892 responses. After removing duplicate and blank responses, 1,813 responses were available for analysis. They represented all hospital practice settings for maternity and newborn care and included nurses from small-volume and rural hospitals. Primary concerns of respondents centered on two aspects of patient acuity-the increasing complexity of clinical cases and the need to link nurse staffing standards to patient acuity. Other themes included maintaining current nurse-to-patient ratios, needing help with implementation in the context of economic challenges, and changing wording from "guidelines" to "standards" to promote widespread adoption. CONCLUSION: In a single-question survey, AWHONN members offered rich, detailed recommendations that were used in the updating of the AWHONN nurse staffing standards.


Asunto(s)
Guías como Asunto , Enfermeras y Enfermeros , Personal de Enfermería en Hospital/normas , Recursos Humanos/normas , Femenino , Humanos , Recién Nacido , Enfermería Neonatal , Relaciones Enfermero-Paciente , Parto , Admisión y Programación de Personal , Embarazo , Sociedades de Enfermería
14.
Curr Sports Med Rep ; 20(10): 540-544, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34622819

RESUMEN

ABSTRACT: The 2019 severe acute respiratory syndrome coronavirus 2 has dramatically changed the sports landscape, compelling sports medical providers to adapt to evolving scientific discoveries and adopt ever-changing guidelines that protect our athletes, ourselves, and our staff. To best serve our athletes, providers need to be proactive and anticipate potential complications in providing care for athletes as athletic events resume.


Asunto(s)
Muerte Súbita Cardíaca , Medicina Deportiva/métodos , COVID-19 , Humanos , Guías de Práctica Clínica como Asunto
15.
Pan Afr Med J ; 39: 226, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34630838

RESUMEN

Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus, has affected many lives, health systems and economies across the globe. Countries in both resource-rich and poor have equally been affected. In Ghana, COVID-19 has caused morbidity and mortality among the populace. The first two cases of COVID-19 were reported in Ghana in March 2020. At the onset of the pandemic in Ghana, there were challenges in securing isolation centers and quarantine facilities. Nonetheless, the government of Ghana put in place a number of measures in line with World Health Organization (WHO) guidelines, to halt the spread of the virus. Some measures taken by the government included partial lockdown of areas deemed hotspots for the spread of the virus. In April 2020, Ghana was ranked number one among African countries in administering tests per million people, because of the effective "trace and test" approach. The government of Ghana also encouraged local manufacturing of personal protective equipment, antivirals and hand sanitizers to help meet the demand of the nation. There were also restrictions on public gathering within the early parts of 2020, and these were eased with time. In February 2021, Ghana became the first country to receive vaccines through the COVAX initiative with a delivery of 600,000 doses of Oxford-AstraZeneca vaccines. The efforts by Ghana to deal with the COVID-19 pandemic have been commendable. Not withstanding, the adverse impact of the COVID-19 on public health in Ghana has been significant, and there is still a lot to learn from other countries in the sub-region, and the world as whole.


Asunto(s)
Vacunas contra la COVID-19/administración & dosificación , COVID-19/epidemiología , Salud Pública , Antivirales/administración & dosificación , COVID-19/prevención & control , Ghana/epidemiología , Humanos , Equipo de Protección Personal , Guías de Práctica Clínica como Asunto , Cuarentena
17.
Gastroenterology ; 2021 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-34602251

RESUMEN

Find AGA's NASH Clinical Care Pathway App for iOS and Android mobile devices at nash.gastro.org. Scan this QR code to be taken directly to the website.Nonalcoholic fatty liver disease (NAFLD) is becoming increasingly common, currently affecting approximately 37% of US adults. NAFLD is most often managed in primary care or endocrine clinics, where clinicians must determine which patients might benefit from secondary care to address hepatic manifestations, comorbid metabolic traits, and cardiovascular risks of the disease. Because NAFLD is largely asymptomatic, and because optimal timing of treatment depends on accurate staging of fibrosis risk, screening at the primary care level is critical, together with consistent, timely, evidence-based, widely accessible, and testable management processes. To achieve these goals, the American Gastroenterological Association assembled a multidisciplinary panel of experts to develop a Clinical Care Pathway providing explicit guidance on the screening, diagnosis, and treatment of NAFLD. This article describes the NAFLD Clinical Care Pathway they developed and provides a rationale supporting proposed steps to assist clinicians in diagnosing and managing NAFLD with clinically significant fibrosis (stage F2-F4) based on the best available evidence. This Pathway is intended to be applicable in any setting where care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices.

18.
Eur Urol Focus ; 2021 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-34602368

RESUMEN

Patients are the stewards of their own care and hence their voice is important when designing and implementing research. Patients should be involved not only as participants in research that impacts their care, as the recipients of that care and any associated harms, but also as research collaborators in prioritising important questions from the patient perspective and designing the research and the ways in which is it most appropriate to involve patients. The PIONEER Consortium, an international multistakeholder collaboration lead by the European Association of Urology, has developed a core outcome set (COS) for localised and metastatic prostate cancer relevant to all stakeholders in particular patients. Throughout the work of PIONEER, patient representatives were involved as collaborators in setting the research agenda, and a wider group of patients was involved as participants in developing COSs, for instance in consensus meetings on choosing important outcomes and appropriate definitions. This publication showcases the process for COS development and highlights the most important recommendations to ultimately inform future research projects co-created between patients and other stakeholders. PATIENT SUMMARY: An important step in involving patients in the selection of outcomes for clinical trials, clinical audits, and real-world evidence is the development of a core outcome set (COS) that is relevant to all stakeholders. This report highlights the patient participation throughout our PIONEER COS development. TAKE HOME MESSAGE: An important step in involving patients in the selection of outcomes for clinical trials, clinical audits, and real-world evidence is to develop a core outcome set (COS) that is relevant to all stakeholders. As part of the work of the PIONEER Consortium, we aim to highlight the patient participation throughout our PIONEER COS development.

19.
Anaesth Crit Care Pain Med ; : 100901, 2021 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-34602381

RESUMEN

OBJECTIVE: To provide national guidelines for the management of women with severe pre-eclampsia. DESIGN: A consensus committee of 26 experts was formed. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. METHODS: The last SFAR and CNGOF guidelines on the management of women with severe pre-eclampsia were published in 2009. The literature is now sufficient for an update. The aim of this expert panel guidelines is to evaluate the impact of different aspects of the management of women with severe preeclampsia on maternal and neonatal morbidities separately. The experts studied questions within 7 domains. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analysed according to the GRADE® methodology. RESULTS: The SFAR/CNGOF experts panel provided 25 recommendations: 8 have a high level of evidence (GRADE 1+/-), 9 have a moderate level of evidence (GRADE 2+/-), and for 7 recommendations, the GRADE method could not be applied, resulting in expert opinions. No recommendation was provided for 3 questions. After one scoring round, strong agreement was reached between the experts for all the recommendations. CONCLUSIONS: There was strong agreement among experts who made 25 recommendations to improve practices for the management of women with severe pre-eclampsia.

20.
Pan Afr Med J ; 39: 222, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34630834

RESUMEN

Introduction: irrational or inappropriate prescribing of antibiotics is a major problem in healthcare and leads to antibiotic resistance. There is the need to understand the prescribing patterns and antibiotic stewardship in health facilities to support appropriate antibiotic use. A study was carried out to evaluate prescribing pattern of antibiotics at the Ghana Police Hospital using National Standard Treatment Guidelines (STG) and World Health Organization (WHO) prescribing indicators. Methods: a cross-sectional descriptive study was conducted at the Ghana Police Hospital. Data on prescriptions of antibiotics for both out-patients and in-patients was collected between December 2019 and March 2020. A pretested self-designed tool was used for data collection. All sampled prescriptions were assessed for appropriateness using the STG of 2017 and WHO "AWaRe" classification. The criteria used in assessment included dose, frequency, duration of treatment and choice of antibiotic prescribed for disease condition. Descriptive statistics were used in data analysis. Results: a total of 184 patient prescriptions (286 antibiotics) were included in this study. Results showed that antibiotics were mostly prescribed for dental and dental-related conditions (20.7%) and obstetric post-delivery prophylaxis (18.1%). Appropriateness of indicators for antibiotics prescribed assessed ranged between 89.2% to 97.6%. The most frequently prescribed antibiotics were metronidazole (25.9%), amoxicillin with clavulanic acid (22.0%), amoxicillin (16.4%) and ciprofloxacin (10.1%). Based on WHO "AWaRe" classification, the "access" group of antibiotics (74%) was the most prescribed, followed by "watch" group (24%). There were no antibiotics prescribed from the "reserve" group of antibiotics and another 2% that was not part of AwaRe classification. Conclusion: study revealed that the level of appropriateness for prescribing indicators assessed was relatively high and majority of prescribed antibiotics were from the "access" and "watch" group. These observations suggest responsible prescribing of antibiotics at the Ghana Police Hospital and effective antibiotic stewardship should be sustained and improved.


Asunto(s)
Antibacterianos/administración & dosificación , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adolescente , Adulto , Anciano , Programas de Optimización del Uso de los Antimicrobianos , Niño , Preescolar , Estudios Transversales , Femenino , Ghana , Hospitales , Humanos , Prescripción Inadecuada/estadística & datos numéricos , Lactante , Masculino , Persona de Mediana Edad , Proyectos Piloto , Pautas de la Práctica en Medicina/normas , Indicadores de Calidad de la Atención de Salud , Adulto Joven
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