MA PCMH Eval Week: Ann Lawthers, Sai Cherala, and Judy Steinberg on How You Define Success Influences Your Findings

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness. This blog post was posted to AEA365 during a week of posts featuring the team at the University of Massachusetts Medical School that helped to evaluate the Massachusetts Patient-Centered Medical Home Initiative

A Prospective Observational Study on Rational Use of Antibiotics for Paediatric Patients with Respiratory Tract Infections in a Tertiary Care Hospital

Background: Antibiotic drug overuse and inappropriate antibiotic drug selection are associated with increased drug resistance among respiratory pathogens (most notably, Streptococcus pneumoniae), possible progression to chronic disease, and increased treatment costs.[1] The selection of an antibiotic for prophylaxis should be based on known or likely target pathogens, for a short duration of time. Objective: To evaluate Rational use of antibiotics in Paediatric patients suffering from Respiratory tract    infections. Method: It was Prospective, observational study conducted by random selection of patients. Based on diagnosis, the study population was categorized into 2 groups: Upper respiratory tract infections and Lower respiratory tract infections. The study population was interviewed after obtaining written informed consent for information like demographics, diagnosis, treatment and antibiotics prescribed. Results and Discussion: In our study population, it was observed that male patient (74%) were higher than female patients (26%). Total number of antibiotics prescribed during the study period is 83. Most commonly prescribed antibiotic was Augmentin (Amoxicillin +Clavulanic acid) of dose (450mg IV BD) which is the combination drug, i.e, more effective than individual antibiotic drugs. Conclusion: In the present study it is observed that 4-different classes of antibiotics-Pencillins,Cephalosporins,Macrolides and Aminoglycosides were prescribed and used for different Respiratory diseases.The percentage of average antibiotic utilization is highest in Lower Respiratory Tract Infection with (55.22%).Mostly used Antibiotic in males for both LRTI and URTI is Augmentin with the percentage of (52%) and (80%) respectively.Where as in females it is observed that in both LRTI and URTI mostly used Antibiotic is Augmentin with percentage of (38.8%) and( 80%) respectively.Overall Second mostly used antibiotic is Ceftriaxone. Keywords: pediatrics, lower and upper respiratory tract infections, antibiotics.&nbsp

Tacrolimus Pharmacokinetics in Hispanic Children After Kidney Transplantation

Ethnic differences in drug pharmacokinetics are well recognized including that for tacrolimus (TAC) in adult subjects. However, similar knowledge among pediatric populations is missing. Our limited retrospective study compares steady-state pharmacokinetics of TAC in Hispanic versus non-Hispanic children. Serial blood samples were collected and whole blood concentrations of TAC were measured using radioimmunoassay. Compared with non-Hispanic children, Hispanic children had lower measures of drug exposure (maximum drug concentration [C(subscript max)] and area under the drug concentration-time curve [AUC(subscript 0-∞)]), higher volume of distribution, and faster clearance. Interestingly, only in Hispanic children, significant correlations were found between body weight and clearance, age and volume of distribution, and Schwartz estimated glomerular filtration rate and half-life. In conclusion, our study suggests that ethnic differences exist between Hispanic and non-Hispanic children in TAC PK, and based on our preliminary findings, either a higher or more frequent TAC dosing may be required for effective immunosuppression therapy in Hispanic children