The Point Prevalence Survey Research of Antibacterial Drugs’ Prescription for Outpatient Treatment of Urinary System Infections

BACKGROUND: Antibiotic resistance of microorganisms is the subject of numerous discussions and initiatives, it has a well-defined tendency to increase which is largely related to a big number of errors when prescribing antibacterial drugs at the outpatient stage of treatment and disease prevention, as well as a lack of information and data on the quantity and quality of antimicrobial therapy. One of the elements aimed at reducing antibiotic resistance growth is audit and analysis of application practice. AIM: To assess qualitative and quantitative characteristics for urinary tract infections treatment using antimicrobial drugs by general physicians at the outpatient level. MATERIALS AND METHODS: The Point Prevalence Survey (PPS) analysis of antimicrobial drugs prescription was conducted by general physicians of No. 1, 4, 5 Hospitals of Karaganda city. There was carried out a daily prospectively data collecting on antibacterial drugs prescription by Doctor of Medical institutions, which was performed during patients’ visit. For each person who was prescribed the AD, there was filled a special questionnaire developed by the European Center for Disease Prevention and Control, including passport data, data on disease and prescription of antibacterial drugs. There were considered 200 cases of antibiotic prescription. The study included patients of both sexes, all age groups, who were prescribed the antibiotic therapy for the UTI treatment. RESULTS: When selecting antimicrobial therapy, the Protocols for diagnosis and treatment indicate the need for a microbiological study to determine sensitivity to antibacterial drugs, that was not performed in 100% of cases, and initial treatment was empirically prescribed, namely, in 34% of cases there were used drugs from the cephalosporin group (Ceftriaxone), nitrofurans (Furazidin)-42%, fluoroquinolones (Levofloxacin)-24%. In treating acute cystitis, in most cases, alternative medications were prescribed, though according to current recommendations, first-line therapy includes fosfomycin trometamol, pivmecillins and nitrofurantoin macrocrystals, which according to the results of this study were not used at all. CONCLUSION: In most cases (71%), alternative antibacterial drugs were prescribed for initial treatment of urinary tract infections. In majority cases, the dosage regimen of antibacterial drugs, dosage frequency, treatment course did not meet current recommendations

Informative Nature and Nonlinearity of Lagged Poincaré Plots Indices in Analysis of Heart Rate Variability

Lagged Poincaré plots have been successful in characterizing abnormal cardiac function. However, the current research practices do not favour any specific lag of Poincaré plots, thus complicating the comparison of results of different researchers in their analysis of heart rate of healthy subjects and patients. We researched the informative nature of lagged Poincaré plots in different states of the autonomic nervous system. It was tested in three models: different age groups, groups with different balance of autonomous regulation, and in hypertensive patients. Correlation analysis shows that for lag l = 6, SD1/SD2 has weak (r = 0.33) correlation with linear parameters of heart rate variability (HRV). For l more than 6 it displays even less correlation with linear parameters, but the changes in SD1/SD2 become statistically insignificant. Secondly, surrogate data tests show that the real SD1/SD2 is statistically different from its surrogate value and the conclusion could be made that the heart rhythm has nonlinear properties. Thirdly, the three models showed that for different functional states of the autonomic nervous system (ANS), SD1/SD2 ratio varied only for lags l = 5 and 6. All of this allow to us to give cautious recommendation to use SD1/SD2 with lags 5 and 6 as a nonlinear characteristic of HRV. The received data could be used as the basis for continuing the research in standardisation of nonlinear analytic methods