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[PMID]:29292905
[Au] Autor:Henriksson R; Falkenius J; Norin S; Öhman D; Abrahamsson M; Lindquist M; Lööv SÅ
[Ad] Endereço:Onkologi & Patologi - Regionalt Cancercentrum STOCKHOLM, Sweden Onkologi & Patologi - Regionalt Cancercentrum STOCKHOLM, Sweden.
[Ti] Título:Register för nya läkemedel i cancervården ger värdefull hjälp - Visar en bra bild av hur läkemedlen används ­ patienten kan följas i den kliniska vardagen..
[So] Source:Lakartidningen;114, 2017 Nov 06.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:Register for new drugs in cancer care provides a picture of how the drugs are used in the daily clinical practice Today, an increasing number of cancer drugs are approved before traditional well-controlled phase 3 studies have been conducted and in many registration studies there is no participation of Swedish departments. This article describes the general experience of a caregiver initiated systematic follow-up of new cancer drugs that shows the possibility of obtaining a picture of the drug's use in routine care. From the register "New Pharmaceuticals in Cancer care", registrations from Stockholm-Gotland region are reported. The structure of the registry can be used with advantage in other therapeutic areas than cancer and can be supplemented with data from national and regional registers as well as quality registers including patient experiences. The knowledge is important to many actors in health care and can contribute to an evidence based, patient-safe and equal healthcare in accordance with current guidelines.
[Mh] Termos MeSH primário: Antineoplásicos
Neoplasias/tratamento farmacológico
Sistema de Registros
[Mh] Termos MeSH secundário: Androstenos/uso terapêutico
Antineoplásicos/administração & dosagem
Antineoplásicos/uso terapêutico
Bevacizumab/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Neoplasias da Mama/mortalidade
Neoplasias Colorretais/tratamento farmacológico
Neoplasias Colorretais/mortalidade
Uso de Medicamentos
Seres Humanos
Ipilimumab/uso terapêutico
Masculino
Melanoma/tratamento farmacológico
Melanoma/mortalidade
Neoplasias/mortalidade
Cuidados Paliativos/métodos
Feniltioidantoína/análogos & derivados
Feniltioidantoína/uso terapêutico
Projetos Piloto
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/mortalidade
Rádio (Elemento)/uso terapêutico
Taxa de Sobrevida
Suécia/epidemiologia
Suspensão de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androstenes); 0 (Antineoplastic Agents); 0 (Ipilimumab); 0 (MDV 3100); 0 (Radium-223); 2010-15-3 (Phenylthiohydantoin); 2S9ZZM9Q9V (Bevacizumab); G819A456D0 (abiraterone); W90AYD6R3Q (Radium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29292933
[Au] Autor:Ringbom T; Salin K; Scholz B; Hillver SE; Ljung R
[Ti] Título:Tonvis med diklofenak i våra vatten ­ regeländring behövs..
[So] Source:Lakartidningen;114, 2017 11 17.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/análise
Diclofenaco/análise
Legislação de Medicamentos
Qualidade da Água/normas
[Mh] Termos MeSH secundário: Anti-Inflamatórios não Esteroides/metabolismo
Diclofenaco/metabolismo
Prescrições de Medicamentos
Uso de Medicamentos
Seres Humanos
Suécia
Águas Residuais/análise
Poluentes Químicos da Água/análise
Poluentes Químicos da Água/metabolismo
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Waste Water); 0 (Water Pollutants, Chemical); 144O8QL0L1 (Diclofenac)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29311458
[Au] Autor:Sasaoka S; Hatahira H; Hasegawa S; Motooka Y; Fukuda A; Naganuma M; Umetsu R; Nakao S; Shimauchi A; Ueda N; Hirade K; Iguchi K; Nakamura M
[Ad] Endereço:Laboratory of Drug Informatics, Gifu Pharmaceutical University.
[Ti] Título:[Adverse Event Trends Associated with Over-the-counter Combination Cold Remedy: Data Mining of the Japanese Adverse Drug Event Report Database].
[So] Source:Yakugaku Zasshi;138(1):123-134, 2018.
[Is] ISSN:1347-5231
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:OTC combination cold remedies are widely used in Japan. In the present study, we aimed to evaluate the adverse event profiles of OTC combination cold remedy based on the components using the Japanese Adverse Drug Event Report (JADER) database. The JADER database contained 430587 reports between April 2004 and November 2016. 1084 adverse events associated with the use of OTC combination cold remedy were reported. Reporting odds ratio (ROR) was used to detect safety signals. The ROR values for "skin and subcutaneous tissue disorders", "hepatobiliary disorders", and "immune system disorders" stratified by system organ class of the Medical Dictionary for Regulatory Activities (MedDRA) were 9.82 (8.71-11.06), 2.63 (2.25-3.07), and 3.13 (2.63-3.74), respectively. OTC combination cold remedy containing acetaminophen exhibited a significantly higher reporting ratio for "hepatobiliary disorders" than OTC combination cold remedy without acetaminophen. We demonstrated the potential risk of OTC combination cold remedy in a real-life setting. Our results suggested that the monitoring of individuals using OTC combination cold remedy is important.
[Mh] Termos MeSH primário: Acetaminofen/efeitos adversos
Sistemas de Notificação de Reações Adversas a Medicamentos
Mineração de Dados
Bases de Dados Factuais
Uso de Medicamentos/estatística & dados numéricos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Medicamentos sem Prescrição/efeitos adversos
[Mh] Termos MeSH secundário: Acetaminofen/administração & dosagem
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos
Doenças Biliares/induzido quimicamente
Doenças Biliares/epidemiologia
Doença Hepática Induzida por Substâncias e Drogas/epidemiologia
Doença Hepática Induzida por Substâncias e Drogas/etiologia
Combinação de Medicamentos
Doenças do Sistema Imune/induzido quimicamente
Doenças do Sistema Imune/epidemiologia
Japão/epidemiologia
Medicamentos sem Prescrição/administração & dosagem
Razão de Chances
Risco
Dermatopatias/induzido quimicamente
Dermatopatias/epidemiologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drug Combinations); 0 (Nonprescription Drugs); 362O9ITL9D (Acetaminophen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1248/yakushi.17-00172


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[PMID]:29390443
[Au] Autor:Ye F; Wu Y; Zhou C
[Ad] Endereço:Department of Anesthesiology, Xiangyang Central Hospital (The Affiliated Hospital of Hubei University of Arts and Science), Xiangyang, China.
[Ti] Título:Effect of intravenous ketamine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A meta-analysis.
[So] Source:Medicine (Baltimore);96(51):e9147, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a meta-analysis to assess the efficacy and safety of ketamine for reducing pain and narcotic use for patients undergoing laparoscopic cholecystectomy (LC). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) were regarded as eligible in our study. After testing the heterogeneity across RCTs, data were aggregated for fixed/random effect model according to the I statistic. The meta-analysis was conducted using Stata 11.0 software. RESULTS: Five studies were included, with a total sample size of 212 patients. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours [standard mean difference (SMD) = -0.322, 95% confidence interval (95% CI): -0.594 to -0.050, P = .020], 24 hours (SMD = -0.332, 95% CI: -0.605 to -0.059, P = .017), and 48 hours (SMD = -0.340, 95% CI: -0.612 to -0.068, P = .014). Ketamine intervention was found to significantly decrease narcotic use at 12 hours (SMD = -0.296, 95% CI: -0.567 to -0.025, P = .033), 24 hours (SMD = -0.310, 95% CI: -0.581 to -0.039, P = .025), and 48 hours (SMD = -0.338, 95% CI: -0.609 to -0.066, P = .015). CONCLUSION: Ketamine appeared to significantly reduce postoperative pain and narcotic use following LC. On the basis of the current evidence available, higher quality RCTs are still required for further research.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Colecistectomia Laparoscópica
Ketamina/uso terapêutico
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Uso de Medicamentos
Seres Humanos
Infusões Intravenosas
Entorpecentes/uso terapêutico
Medição da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Narcotics); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009147


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[PMID]:29348222
[Au] Autor:Hornung CH
[Ad] Endereço:CSIRO Manufacturing, Private Bag 10, Clayton South, Victoria 3169, Australia. christian.hornung@csiro.au.
[Ti] Título:The art of manufacturing molecules.
[So] Source:Science;359(6373):273-274, 2018 01 19.
[Is] ISSN:1095-9203
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Projeto Auxiliado por Computador
Impressão Tridimensional
[Mh] Termos MeSH secundário: Engenharia Química
Uso de Medicamentos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1126/science.aar4543


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[PMID]:28745065
[Au] Autor:Rojas-Fernandez CH; Goh J; Hartwick J; Auber R; Zarrin A; Warkentin M; Hudani Z
[Ad] Endereço:1 CRF Health Outcomes Research Consulting, Waterloo, Ontario, Canada.
[Ti] Título:Assessment of Oral Anticoagulant Use in Residents of Long-Term Care Homes: Evidence for Contemporary Suboptimal Use.
[So] Source:Ann Pharmacother;51(12):1053-1062, 2017 Dec.
[Is] ISSN:1542-6270
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the quality of warfarin use in residents of long-term care facilities and investigate potential predictors oral anticoagulant use. DESIGN: Retrospective chart review (August 2013 to September 2014). SETTING: Thirteen long-term care (LTC) and assisted living facilities (ALF). PARTICIPANTS: Residents from LTC or ALF settings who ( a) received warfarin or direct-acting oral anticoagulants (DOACs) and ( b) residents with a valid indication for oral anticoagulants such as atrial fibrillation, venous thromboembolism, but were not receiving these drugs. PRIMARY OUTCOME: Time in therapeutic international normalized ratio (INR) range (TTR). RESULTS: A total of 563 residents (70% female) with an average age of 85 years were identified. Participants had an average of 7.5 comorbidities and 9 medications. A total of 391 (69%) residents with indications for OACs were receiving such medications. Indications were atrial fibrillation (63%), venous or pulmonary embolism (16%), cardiac valves (0.4%); 26% did not have documented indications. Warfarin and DOACs were prescribed for 213 (38%) and 178 (32%) respectively, and 172 (31%) received no OACs The TTR ranged from 56%-75% (mean 63%). The frequency of INR determinations ranged from every 7 to 20 days, (mean 13 days) with no apparent relationship between frequency of testing and TTR. CONCLUSION: The TTR was higher (63.8%) than literature average (50%), but remains suboptimal given expected benefits of TTRs >75% versus TTRs circa 60%. Documentation of indications for OACs needs improvement, and it is possible that OACs are underused. Further work is necessary to understand how OAC use may be optimized in these facilities.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Assistência de Longa Duração/estatística & dados numéricos
Varfarina/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Idoso
Idoso de 80 Anos ou mais
Moradias Assistidas/estatística & dados numéricos
Fibrilação Atrial/tratamento farmacológico
Uso de Medicamentos/estatística & dados numéricos
Feminino
Seres Humanos
Coeficiente Internacional Normatizado
Masculino
Estudos Retrospectivos
Tromboembolia Venosa/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 5Q7ZVV76EI (Warfarin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1177/1060028017723348


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Registro de Ensaios Clínicos
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[PMID]:28455085
[Au] Autor:Altenau B; Crisp CC; Devaiah CG; Lambers DS
[Ad] Endereço:Department of Obstetrics and Gynecology, TriHealth Hospitals, Cincinnati, OH.
[Ti] Título:Randomized controlled trial of intravenous acetaminophen for postcesarean delivery pain control.
[So] Source:Am J Obstet Gynecol;217(3):362.e1-362.e6, 2017 09.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009. Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. OBJECTIVE: The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain. STUDY DESIGN: This was an institutional review board-approved, double-blind, placebo-controlled, randomized trial, registered on clinicaltrials.gov (number 02046382). Women scheduled to undergo cesarean delivery with regional anesthesia at term were recruited. All perioperative and postpartum care was standardized via study order sets. Study patients were given all medications in a standardized manner receiving either acetaminophen 1000 mg intravenously or 100 mL saline (placebo) every 8 hours for 48 hours for a total of 6 doses. The pharmacy prepared intravenous acetaminophen and saline in identical administration bags labeled study drug to ensure blinding. The initial dose of study drug was given within 60 minutes of skin incision. Quantity of breakthrough and scheduled analgesic medications and self-reported pain levels on the Faces Pain Scale (0-10) before and after study drug administration were collected. Patient demographics were extracted from the chart. Power calculation determined that 45 patients per arm were required to detect a 30% reduction in postcesarean narcotic requirement with 80% power and a significance level of P = .05. RESULTS: A total of 133 patients were consented for the study. Twenty-nine were excluded and 104 patients completed the study: 57 received intravenous acetaminophen and 47 received placebo. There were no differences in baseline demographic characteristics including patient age, body mass index, gravidity, parity, race, comorbidities, or number of prior cesarean deliveries. There were no differences between groups in estimated blood loss or length of stay. The total amount of oral narcotic medications consumed by patients receiving intravenous acetaminophen was significantly reduced when compared with the placebo group (47 mg vs 65 mg of oxycodone; P = .034). The total amount of ibuprofen used between groups was not different. There was no difference in pain scores between groups before and after study dose administration. There was no significant difference in narcotic side effects (nausea/emesis, respiratory depression, constipation) in either study arm. CONCLUSION: Intravenous acetaminophen in the postoperative period following cesarean delivery resulted in a significant decrease in oral narcotic consumption for pain control.
[Mh] Termos MeSH primário: Acetaminofen/uso terapêutico
Analgésicos não Entorpecentes/uso terapêutico
Cesárea
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Analgésicos Opioides/uso terapêutico
Método Duplo-Cego
Uso de Medicamentos/estatística & dados numéricos
Feminino
Seres Humanos
Infusões Intravenosas
Oxicodona/uso terapêutico
Medição da Dor
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Analgesics, Opioid); 362O9ITL9D (Acetaminophen); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180119
[Lr] Data última revisão:
180119
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:27777360
[Au] Autor:Hwang AY; Dave C; Smith SM
[Ad] Endereço:From the Department of Pharmacotherapy and Translational Research (A.Y.H., S.M.S.) and Department of Pharmaceutical Outcomes and Policy (C.D.), College of Pharmacy, and Department of Community Health and Family Medicine, College of Medicine (A.Y.H., S.M.S.), University of Florida, Gainesville.
[Ti] Título:Trends in Antihypertensive Medication Use Among US Patients With Resistant Hypertension, 2008 to 2014.
[So] Source:Hypertension;68(6):1349-1354, 2016 12.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Little is known of US trends in antihypertensive drug use for patients with treatment-resistant hypertension (TRH). We analyzed antihypertensive use among patients with TRH (treated with ≥4 antihypertensive drugs concurrently) from July 2008 through December 2014 using Marketscan administrative data. We included adults aged 18 to 65 years, with ≥6 months of continuous enrollment, a hypertension diagnosis, and ≥1 episode of overlapping use of ≥4 antihypertensive drugs; patients with heart failure were excluded. We identified 411 652 unique TRH episodes from 261 652 patients with a mean age of 55.9 years. From 2008 to 2014, we observed an increased prevalence, among TRH episodes, of ß-blockers (+6.8% [79% to 85.8%]) and dihydropyridine calcium antagonists (+8.1% [69.1% to 77.2%]), and a decreased prevalence of angiotensin-converting enzyme inhibitors (-12.5% [60.4% to 47.9%]) and nondihydropyridine calcium antagonists (-5.0% [15% to 10%]). The prevalence of most other classes changed by <5% from 2008 to 2014. Thiazide diuretic use was largely unchanged from 2008 to 2014, with hydrochlorothiazide being by far the most prevalent thiazide diuretic; chlorthalidone use increased only modestly (+2.6% [3.8% to 6.4%]). Aldosterone antagonist use increased only modestly (+2.9% [7.3% to 10.2%]). Use of optimal regimens increased steadily (+13.8% [50.8% to 64.6%]) during the study period, whereas combined angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use declined (-11.4% [17.7% to 6.3%]). Our results highlight the persistent infrequent use of recommended therapies in TRH, including spironolactone and chlorthalidone, and suggest a need for better efforts to increase the use of such approaches in light of recent evidence demonstrating their efficacy.
[Mh] Termos MeSH primário: Anti-Hipertensivos/uso terapêutico
Clortalidona/uso terapêutico
Resistência a Medicamentos
Hipertensão/diagnóstico
Hipertensão/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Anti-Hipertensivos/farmacologia
Determinação da Pressão Arterial/métodos
Bloqueadores dos Canais de Cálcio/uso terapêutico
Estudos de Coortes
Quimioterapia Combinada
Uso de Medicamentos/tendências
Feminino
Seguimentos
Seres Humanos
Hidroclorotiazida/uso terapêutico
Masculino
Meia-Idade
Segurança do Paciente
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Espironolactona/uso terapêutico
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Antihypertensive Agents); 0 (Calcium Channel Blockers); 0J48LPH2TH (Hydrochlorothiazide); 27O7W4T232 (Spironolactone); Q0MQD1073Q (Chlorthalidone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29228415
[Au] Autor:Ohshima T; Asai S; Miyazawa M; Yamamoto Y; Hisada A; Kumazawa C; Hashimoto M; Fukawa K; Iwashita H; Umezawa K; Yamada S; Yamamoto Y; Miyachi H
[Ti] Título:The Implementation of a Hospital-wide Practice for the Selective Use of Carbapenems Based on the Monitoring of Susceptibility of Pseudomonas aeruginosa Isolates.
[So] Source:Tokai J Exp Clin Med;42(4):176-181, 2017 Dec 20.
[Is] ISSN:2185-2243
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To control carbapenem-resistant Pseudomonas aeruginosa, we implemented a hospital-wide policy concerning the selective use of carbapenems based on the monitoring of P. aeruginosa isolates for susceptibility to five carbapenems using a customized dry plate method. In this study, we retrospectively investigated the outcome of our measures to control carbapenem-resistant P. aeruginosa. METHODS: To select effective carbapenems, 100 clinical isolates were collected, and the minimum inhibitory concentration (MIC) to 5 carbapenems (IPM/CS, MEPM, DRPM, BIPM and PAPM/BP) was monitored using a customized dry plate method from 2006 to 2013. Carbapenems, which were associated with a high rate of drug resistance in P. aeruginosa, were restricted from use during our intervention study. The antimicrobial use density per 100 bed-days (AUD ) of carbapenems and the detection rates of carbapenem (IPM/CS and MEPM)-resistant P. aeruginosa were determined during the period of the intervention. RESULTS: The isolates consistently showed higher rates of drug-resistant P. aeruginosa in IPM/CS and PAPM/BP. Thus, DRPM, MEPM and BIPM were adopted for hospital-wide use. The detection rates of all IPM/Cs and MEPM-resistant P. aeruginosa significantly decreased. Meanwhile, the consumption of carbapenems showed an increasing trend. CONCLUSIONS: The outcome of the hospital-wide implementation of the selective use of carbapenems based on periodic monitoring of the susceptibility of P. aeruginosa isolates was retrospectively studied. Implementation of this measure might have contributed in part to the control of carbapenem-resistant P. aeruginosa in our hospital.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Carbapenêmicos/farmacologia
Hospitais
Controle de Infecções/métodos
Pseudomonas aeruginosa/efeitos dos fármacos
[Mh] Termos MeSH secundário: Monitoramento de Medicamentos
Farmacorresistência Bacteriana
Uso de Medicamentos/estatística & dados numéricos
Uso de Medicamentos/tendências
Seres Humanos
Testes de Sensibilidade Microbiana/métodos
Análise de Regressão
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Carbapenems)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29215508
[Au] Autor:Madsen AM; Stark LM; Has P; Emerson JB; Schulkin J; Matteson KA
[Ad] Endereço:Department of Obstetrics and Gynecology, Women & Infants' Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island; and the Research Department of the American College of Obstetricians and Gynecologists, Washington, DC.
[Ti] Título:Opioid Knowledge and Prescribing Practices Among Obstetrician-Gynecologists.
[So] Source:Obstet Gynecol;131(1):150-157, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe obstetrician-gynecologists' (ob-gyns) knowledge and prescribing practices regarding opioid analgesics. METHODS: We conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who are part of the Collaborative Ambulatory Research Network. We used a sequential mixed-method approach. We collected data on opioid knowledge and typical prescribing practices, including number, type, and indication for prescriptions. We determined adherence to four recommended practices: 1) screening for dependence, 2) prescribing the smallest amount required, 3) tailoring prescriptions, and 4) counseling on proper disposal. We also explored variables associated with prescribing practices. RESULTS: Sixty percent (179/300) of sampled members responded. Respondents reported prescribing a median of 26 (5-80) pills per patient across all indications combined. Ninety-eight percent prescribed opioids after surgery and a smaller proportion for nonsurgical indications: vaginal birth (22%), ovarian cysts (30%), endometriosis (24%), and chronic pelvic pain of unknown cause (18%). The number prescribed varied only by indication for the prescription. Nineteen percent reported adherence to three or more (of four) recommended practices. There was no significant difference in the median number of pills prescribed between those who reported adherence to at least one compared with those who did not adhere to any recommended practices (25 [interquartile range 25-30] vs 28 [interquartile range 20-30], P=.58). Regarding knowledge, 81% incorrectly identified the main source of misused opioids, which is through diversion from a friend or family member, and 44% did not know how to properly dispose of unused prescription opioids. CONCLUSION: Obstetrician-gynecologists reported prescribing a median of 26 opioid pills across all indications combined. Amount prescribed varied widely by indication but not by reported adherence to recommended prescribing practices. This study highlights an urgent need for increased efforts to improve ob-gyns' knowledge of opioid use, misuse, disposal, and best prescribing practices.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Prescrições de Medicamentos/estatística & dados numéricos
Uso de Medicamentos/estatística & dados numéricos
Transtornos Relacionados ao Uso de Opioides/prevenção & controle
Padrões de Prática Médica/tendências
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos
Atitude do Pessoal de Saúde
Estudos Transversais
Uso de Medicamentos/tendências
Feminino
Ginecologia/métodos
Seres Humanos
Masculino
Determinação de Necessidades de Cuidados de Saúde
Obstetrícia/métodos
Transtornos Relacionados ao Uso de Opioides/etiologia
Estatísticas não Paramétricas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002407



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