Drug use evaluation of cotrimoxazole prophylaxis in people living with human immunodeficiency virus/acquired immune deficiency syndrome at Jimma University Specialized Hospital, Jimma, South West of Ethiopia, 2013

Background: Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to advice optimal patient outcomes. Pneumocystis carinii pneumonia (PCP) is the most common acquired immune deficiency syndrome (AIDS) defining illness. Antibiotics being the most commonly prescribed group of drugs the problem of its overuse are a global phenomenon. Cotrimoxazole (CTX) preventive therapy (CPT) was shown effectively prevents PCP in patients with clinical evidence of immune suppression. CTX has been widely used as a treatment for common infections in many resource limited areas and as a result, CTX resistance among these pathogens has increased dramatically. In response to these problems, this study aims to evaluate the use CTX prophylaxis for opportunistic infections in human immunodeficiency virus (HIV) patients at Jimma University Specialized Hospital (JUSH).Methods: The study was done with retrospective cross-sectional review of medical records of HIV patients who have been on CTX prophylaxis in the hospital during September 11, 2012-September 10, 2013. To maintain the validity of data, the whole 135 patient cards were included in the study within the specified period. Data were collected from January 16, 2013 to February 15, 2013 using structured data collection format.Results: From the study subjects, 82 (60.74%) were females 85.93% of patients were used appropriate dose of CPT and 13.3% patients use CTX against contraindication. Regarding to adverse drug reactions (ADRs), 3.7% of patients were developed rash while 2.2% cases were developed nausea during the follow-up period of CPT. However, only 5.9% patients have documented information about ADR of CPT. On the top of this, CD4 count and hemoglobin test were done for 82.96%, 64.4% patients respectively during initiation of CPT. However, renal function tests were performed only for 2.96% of patients while initiating CPT.Conclusion: The use of CPT for people living with HIV/AIDS was found to be good in JUSH with regard to initiation and dosage. However, the practice of discontinuation of CTX, documentation of ADRs and follow-up for adverse effects of CTX should be improved by proper implementation and adhering to the national guideline of CPT

Drug utilization review of ciprofloxacin in the outpatient department of Boru Meda Hospital, South Wollo Zone, Amhara Region, Ethiopia

Background: The antimicrobial agents developed during the last 60 years are among the most dramatic examples of the advances of modern medicine. Many infectious diseases once considered incurable and lethal are now amenable to treatment with a few pills. They are among the most frequently prescribed medications to day although microbial resistance due to evolutionary and misuse threatens their continued efficacy. One mechanism to ensure correct prescribing and use is drug use evaluations studies. Objective of current study is to evaluate retrospectively of ciprofloxacin use from outpatient medical records by using pre- set criteria in Boru Meda hospital.Methods: A cross-sectional study on retrospectively collected data was used to evaluate ciprofloxacin use from outpatient medical history records existing from January 18, 2009 to January 17, 2010. Criteria along with thresholds set by experts for undertaking drug use evaluation for ciprofloxacin was used which is modified based on Ethiopian National Drug Formulary and Ethiopian National Standard Treatment Guideline, which are used in the hospital. Data was collected from January 18 to January 25, 2010 using appropriate data collection format.Results: Twenty six (65%) patients were in the age group of 15 to 49 years and twenty (50%) were females. Thirty eight (95%) and each of thirty seven (92.5%) cases were consistent with the Ethiopian National Standard Treatment Guideline & drug formulary regarding indication, dose & frequency of ciprofloxacin use in the outpatient department of Boru Meda hospital. 47.5% ciprofloxacin use has problem in duration of treatment . There were potential drug interactions with the drug in 40% of the cases. 10% of ciprofloxacin use was against contraindication.Conclusions: Due From the retrospective Drug Use Evaluation (DUE) study, it was identified that there was inappropriate ciprofloxacin use in the outpatient department of Boru Meda hospital even though the drug’s use regarding indications was a better performance and dosing practices were almost appropriate as per the criteria used for the study (assuming that there were no dose adjustments). There was a great problem concerning the duration of ciprofloxacin drug therapy. Ciprofloxacin use along with potentially interacting drugs and against contraindications was also another problem indicated in the study

Nonadherence and Contributing Factors among Ambulatory Patients with Antidiabetic Medications in Adama Referral Hospital

The objective of this study was to determine the magnitude of nonadherence and its contributing factors among diabetic patients attending the diabetic clinic in Adama Hospital. Methods. This descriptive cross-sectional study was carried out among patients with diabetes mellitus attending the diabetes mellitus clinic of Adama Referral Hospital. Every other patient was selected and data regarding their medication adherence was collected using a structured interview. Data analysis was carried out using SPSS-16. Result. The response rate from this study was 98.3%. A total of 270 patients were interviewed; 51.5% were males. A total of 68.1% of the patients included in the study were married. 14% were younger than 40 years, and 50% were between 40 and 60 years. 21.8% of the participants ascribed their nonadherence to forgetting to take their medications. Patients with duration of diabetes ≤5 years (82.07%) were more compliant to their medication than those with >5 years (60.8%), which was found to be statistically significant (P=0.003). Insulin, 47%, and glibenclamide plus metformin, 43.7%, were the most commonly prescribed mono- and combination therapies, respectively. Common comorbid conditions include hypertension, 148 (54.82%), and visual impairment, 89 (32.96%). The proportion of male patients adherent to their antidiabetic medications was found to be lower than 69.78% compared to the female patients (74.81%), but the difference was not statistically significant (P>0.05). Conclusion. Most diabetic patients are currently being managed with the most effective available drugs. However the result from this study indicates that the desired blood sugar level could not be controlled and maintained adequately. This was because of poor adherence to the prescribed drug regimen and poor knowledge and practice of successful self-management