Assessing Drug Use Indicators in Health Insurance Facilities, Gezira State, Sudan, 2017-2018

Background: Inappropriate use of medicines is a global concern with serious consequences related to prescribing, dispensing, and use. WHO estimated that 50% of medicines are not used correctly on their journey from the facility to home. Objective: To assess medicines use using WHO drug core indicators regarding prescribing, patient, and facilities. Setting: Outpatients, Health centers in Wadmadani locality (Urban area) in Gezira State, Sudan. Method: A cross-sectional, prospective, analytical study was conducted in 30 health centers and 60 patients from each center were selected using a simple random sampling technique. WHO indicators form was used to collect data containing different variables. T-test at a level of confidence of 95% was used to test differences between indicators. Statistical Package for Social Science (SPSS) was used for data analysis. Results: The main prescribing indicators were 2.5 ± 0.6 for drugs per encounter, 44.1% ± 14.2%. Generic 54 ± 18.0 antibiotics, 12.0% ± 9.3% injectable, and 95.2% ± 11.5% of drugs were prescribed according to the NHIF-EML. The main patient’s indicators were, 2.9 ± 0.8 minutes for consultation time, 99.5 ± 36.8 seconds for dispensing time, and 72.5% ± 16.0% for medicines actually dispensed, 49.0% ± 18.0% for medicines adequately labeled, and 22.5% ± 7.3% of the patient’s knowledge about the correct dose. The Facility specific indicators were 66.7% for the availability of a copy of EML, while the percentage of key drugs in the stock was 75.3% ± 11.6%. No statistically significant differences were found between direct and indirect facilities except in generic prescribing. Main Outcome Measure: • Interventions to improve Generic and antibiotics prescribing indicators. • The patient-to-physician ratio should be revised to optimize consultation time. • The availability of key drugs should be improved to make sure effective treatment. • The pharmacy cadre should be oriented and trained to improve patients’ compliance. Conclusion: The study concluded that there was irrational use of medicines when investigated by WHO drug core indicators. So, the study recommended interventions to improve the rationale prescribing, dispensing, and use of medicines.

Analysis of anti-infection therapeutic schedule analysis for neonatal Streptococcus agalactiae meningitis and discussion on the indications for drug withdrawal

The clinical manifestations of neonatal GBS meningitis are as follows:non-specificity,long hospital stay,easy to cause neurological complications,and sequelae.Clinical pharmacist participated in the anti-infective treatment of a neonatal Streptococcus agalactiae meningitis whose cerebrospinal fluid was still abnormal when the drug was stopped.According to the PK/PD characteristics of antibacterial drugs,the permeability of the blood-brain barrier,and the adjustment of the antibiotic dose,the reasons for the decrease in the number of cerebrospinal fluid cells after vancomycin treatment were analyzed.Clinical pharmacists also analyzed the efficacy of linezolid in the treatment of neonatal bacterial meningitis,and discussed the indications for stopping medication when the cerebrospinal fluid is abnormal,so as to improve the safety and effectiveness of antibiotics in the treatment of neonatal bacterial meningitis.