Objective: To evaluate the prescription of antibiotics in patients admitted, in December 2017, to the medical emergencies of the University Hospital Center (UHC) of Cocody. Methodology: A retrospective descriptive and...Objective: To evaluate the prescription of antibiotics in patients admitted, in December 2017, to the medical emergencies of the University Hospital Center (UHC) of Cocody. Methodology: A retrospective descriptive and analytical study of 187 patient files registered from December 1, 2017 to December 31, 2017 at the Cocody UHC’s medical emergencies. All patients aged 16 and over, regardless of sex, nationality and place of residence, having consulted at the Cocody UHC Medical Emergencies and having received antibiotics locally or generally during the study period were included. Patients on antibiotics before admission to medical emergencies or admitted to medical emergencies but not treated with antibiotics or died in medical emergencies before receiving antibiotic therapy were not included in our study. Results: In one month, 265 antibiotic prescription lines were recorded in 187 patients divided into 113 men (60.42%) and 74 women (39.57%) with a sex ratio of 1.52 and an average age of 47.5 years. 58.62% (187/319) of patients had received antibiotic therapy for lung (32.23%), neurological (21.49%) and parasitological (13.22%) affections. Beta-alactamines were the most prescribed molecules (70.57%), mainly in monotherapy and intravenously. Antibiotic therapy was unjustified (66.41%) with a non-compliant dosage (29.43%). The evolution of patients on antibiotics was favourable (50.80%) with however a death in 15.51% of cases. Conclusion: Antibiotic therapy in medical emergency at Cocody University Hospital was based on probabilistic reasoning. This implies that the emergency physician must have a good knowledge of the rules of antibiotics use and that he applies them.展开更多
BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that inf...BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.展开更多
文摘Objective: To evaluate the prescription of antibiotics in patients admitted, in December 2017, to the medical emergencies of the University Hospital Center (UHC) of Cocody. Methodology: A retrospective descriptive and analytical study of 187 patient files registered from December 1, 2017 to December 31, 2017 at the Cocody UHC’s medical emergencies. All patients aged 16 and over, regardless of sex, nationality and place of residence, having consulted at the Cocody UHC Medical Emergencies and having received antibiotics locally or generally during the study period were included. Patients on antibiotics before admission to medical emergencies or admitted to medical emergencies but not treated with antibiotics or died in medical emergencies before receiving antibiotic therapy were not included in our study. Results: In one month, 265 antibiotic prescription lines were recorded in 187 patients divided into 113 men (60.42%) and 74 women (39.57%) with a sex ratio of 1.52 and an average age of 47.5 years. 58.62% (187/319) of patients had received antibiotic therapy for lung (32.23%), neurological (21.49%) and parasitological (13.22%) affections. Beta-alactamines were the most prescribed molecules (70.57%), mainly in monotherapy and intravenously. Antibiotic therapy was unjustified (66.41%) with a non-compliant dosage (29.43%). The evolution of patients on antibiotics was favourable (50.80%) with however a death in 15.51% of cases. Conclusion: Antibiotic therapy in medical emergency at Cocody University Hospital was based on probabilistic reasoning. This implies that the emergency physician must have a good knowledge of the rules of antibiotics use and that he applies them.
文摘BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.