Drugs online research references
Scand J Prim Health Care. 1998 Jun;16(2):121-7.
Prescribing systemic antibiotics in general practice. A report from the More & Romsdal Prescription Study.
Straand J, Rokstad KS, Sandvik H.
Department of Public Health and Primary Health Care, University of Bergen, Norway.
OBJECTIVE: To describe general practitioners' (GPs) prescribing patterns for antibiotics and to compare them with therapeutic guidelines. DESIGN: Cross-sectional, observational study. SETTING: In the Norwegian county More & Romsdal the GPs recorded all contacts with patients and prescriptions during two months. SUBJECTS: 69,843 contacts with 56,758 prescriptions, of which 7905 were for systemic antibiotics. MAIN OUTCOME MEASURES: Prescriptions in relation to diagnosis, kind of consultation, and patients' age and sex. RESULTS: 61% of all antibiotic prescriptions were for females, 26% were issued during indirect contacts, and 14% were repeat prescriptions. Phenoxymethylpenicillin was prescribed most frequently (32%), followed by co-trimoxazole (19%), tetracyclines (18%), erythromycin (16%), and penicillins with extended spectrum (6%). Urinary tract infection was the most frequent diagnosis for antibiotic prescribing (24%), followed by acute bronchitis (13%), ear infections (9%), upper respiratory tract infections (8%), and acute tonsillitis (8.2%). A regression analysis showed that first-time consultations for tonsillitis and otitis, but not for acute bronchitis and pneumonia, patient age 13-64 years, female physician, urban practice location, and a fixed. GP salary were associated with the prescribing of phenoxymethylpenicillin in contrast to other antibiotics. CONCLUSION: Antibiotics are often prescribed for viral infections (e.g., acute bronchitis). Broad spectrum antibiotics are often prescribed for diagnoses where penicillin is recommended as first choice. The issue of antibiotic misuse should be addressed more explicitly in general practice.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9689692&dopt=Abstract
Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):993-5.
Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis.
Brook I, Gober AE.
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
OBJECTIVE: To investigate the persistence of group A beta-hemolytic streptococci (GABHS) in toothbrushes and removable orthodontic appliances (ROAs) in children who suffer from acute GABHS pharyngotonsillitis and the association with penicillin treatment failure. SETTING: Private practice setting. PATIENTS AND METHODS: Pharyngotonsillar and toothbrush cultures were obtained from 104 children with acute GABHS pharyngotonsillitis before and after 10 days of penicillin V potassium therapy. Cultures of ROAs were also obtained from 21 children. The persistence of GABHS in 10 daily rinsed and 10 nonrinsed toothbrushes was studied in vitro. RESULTS: Group A beta-hemolytic streptococci were isolated from 11 (11%) of the toothbrushes and 18 (17%) of the patients after the completion of penicillin therapy. Toothbrushes of 5 (28%) of the 18 children who harbored GABHS were colonized with the organism. Group A beta-hemolytic streptococci were also isolated from 4 (19%) of 21 ROAs after therapy. In vitro studies illustrated the persistence of GABHS in nonrinsed toothbrushes for up to 15 days. In contrast, the organism was not isolated from rinsed toothbrushes beyond day 3. CONCLUSION: Toothbrushes and ROAs that harbor GABHS may contribute to the persistence of GABHS in the oropharynx and may account for the failure of penicillin therapy in some cases of pharyngotonsillitis.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9738808&dopt=Abstract
Ann Otol Rhinol Laryngol. 1998 Sep;107(9 Pt 1):761-4.
Effect of penicillin on formation of fibrous adhesions in acute otitis media.
Caye-Thomasen P, Tos M.
Department of Otorhinolaryngology, Gentofte University Hospital of Copenhagen, Hellerup, Denmark.
Fibrous middle ear adhesions are occasionally encountered in middle ear surgery and may cause a hearing impairment. Although usually associated with chronic otitis media, adhesions are also found following a single episode of experimental acute suppurative otitis media, suggesting a pathogenesis based on the inflammatory process engaging acute infection. In a well-established rat model of pneumococcal acute otitis media, we report on the effect of penicillin V on formation of fibrous middle ear adhesions. Previous studies have shown marked impact of penicillin on mucosal goblet cell density and other histopathologic features. Number, anatomic localization, and histopathologic morphology of adhesions were assessed in a longitudinal study of 25 normal, 25 untreated, and 25 treated rats. Although penicillin administration induced a slight tendency toward fewer ears with adhesions and fewer adhesions per ear, these changes were nonsignificant. Histomorphology and the general pattern of anatomic localization of adhesions were unaffected by penicillin administration. We conclude that administration of penicillin has an inconspicuous effect on the formation of fibrous adhesions in experimental acute otitis media caused by Streptococcus pneumoniae.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9749544&dopt=Abstract
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