Chong, Kam Lin. / Thesis submitted in: December 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 165-174). / Abstracts in English and Chinese. / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.vii / TABLE OF CONTENTS --- p.viii / LIST OF ABBREVIATIONS --- p.xi / Chapter / Chapter 1. --- Introduction --- p.1 / Chapter 2. --- Literature review --- p.10 / Chapter 2.1 --- Prescribing patterns of antibiotics in hospital --- p.12 / Chapter 2.2 --- Worldwide problem of misuse of antibiotics --- p.15 / Chapter 2.2.1 --- Misuse of antibiotics in developed countries --- p.15 / Chapter 2.2.1.1 --- The United States of America --- p.16 / Chapter 2.2.1.2 --- The United Kingdom --- p.19 / Chapter 2.2.1.3 --- Australia --- p.23 / Chapter 2.2.1.4 --- Canada --- p.25 / Chapter 2.2.2 --- Misuse of antibiotics in African countries --- p.27 / Chapter 2.2.3 --- Misuse of antibiotics in Asian countries --- p.30 / Chapter 3. --- Objectives --- p.37 / Chapter 4. --- Methods --- p.39 / Chapter 4.1 --- Subjects --- p.39 / Chapter 4.2 --- Data --- p.41 / Chapter 4.3 --- Definition of terms --- p.44 / Chapter 4.3.1 --- Name of antibiotic --- p.44 / Chapter 4.3.2 --- Antibiotic course and antibiotic therapy --- p.44 / Chapter 4.3.3 --- Indications and types of antibiotic therapy --- p.47 / Chapter 4.3.4 --- Switch therapy --- p.50 / Chapter 4.3.5 --- Types of change --- p.50 / Chapter 4.3.6 --- Causes of change --- p.51 / Chapter 4.3.7 --- Clinical outcome of treatment --- p.53 / Chapter 4.3.8 --- Length of stay --- p.54 / Chapter 4.4 --- Determination of pattern of use --- p.54 / Chapter 4.5 --- Assessment of antibiotic therapies --- p.55 / Chapter 4.5.1 --- Assessment of indication and choice of agent --- p.59 / Chapter 4.5.2 --- Assessment of dosage --- p.60 / Chapter 4.5.3 --- Assessment of route of administration --- p.62 / Chapter 4.5.4 --- Assessment of duration of therapy --- p.62 / Chapter 4.6 --- Features of the guideline developed for the present study --- p.63 / Chapter 4.6.1 --- Ceftriaxone and cefotaxime are appropriate for treating serious infections --- p.72 / Chapter 4.6.2 --- Cefuroxime is not a first line agent --- p.72 / Chapter 4.6.3 --- Regimen for Helicobacter pylori eradication --- p.73 / Chapter 4.7 --- Statistical analysis --- p.73 / Chapter 5. --- Results --- p.74 / Chapter 5.1 --- Antibiotic courses and patients --- p.74 / Chapter 5.1.1 --- Inclusion and exclusion of antibiotic courses --- p.74 / Chapter 5.1.2 --- Patient sex and age --- p.76 / Chapter 5.1.3 --- Chronic disease/past medical history --- p.76 / Chapter 5.1.4 --- Length of stay --- p.78 / Chapter 5.2 --- Pattern of use --- p.79 / Chapter 5.2.1 --- Indications and sites of infection --- p.79 / Chapter 5.2.2 --- Types of antibiotic therapy --- p.83 / Chapter 5.2.3 --- Antibiotics prescribed in initial therapy --- p.84 / Chapter 5.2.4 --- Number of antibiotics in initial therapy --- p.87 / Chapter 5.2.5 --- Prescribing pattern of antibiotics in initial therapy --- p.88 / Chapter 5.2.5.1 --- Prescribing pattern of antibiotics in empirical treatment of lower respiratory tract infections --- p.89 / Chapter 5.2.5.2 --- Prescribing pattern of antibiotics in empirical treatment of sepsis --- p.90 / Chapter 5.2.6 --- Types of change --- p.92 / Chapter 5.2.7 --- Causes of change --- p.92 / Chapter 5.2.8 --- The relationship between causes of change and types of change --- p.93 / Chapter 5.2.9 --- Antibiotics prescribed in switch therapy --- p.96 / Chapter 5.2.10 --- Number of antibiotics in switch therapy --- p.99 / Chapter 5.3 --- Appropriateness of antibiotic therapy --- p.100 / Chapter 5.3.1 --- Appropriateness of empirical therapies --- p.101 / Chapter 5.3.2 --- Appropriateness of directed therapies --- p.102 / Chapter 5.3.3 --- Appropriateness of prophylactic therapies --- p.103 / Chapter 5.3.4 --- Appropriateness of unclassified therapies --- p.104 / Chapter 5.4 --- Clinical outcomes of treatment --- p.105 / Chapter 6. --- Discussion --- p.106 / Chapter 6.1 --- Limitations --- p.106 / Chapter 6.2 --- Method --- p.110 / Chapter 6.2.1 --- Symptom improved and not responded --- p.110 / Chapter 6.2.2 --- Grand round --- p.111 / Chapter 6.2.3 --- Susceptibility test result --- p.111 / Chapter 6.3 --- Results --- p.112 / Chapter 6.3.1 --- Patients --- p.112 / Chapter 6.3.2 --- Pattern of use --- p.113 / Chapter 6.3.2.1 --- Types of therapy --- p.113 / Chapter 6.3.2.2 --- Site of infection --- p.113 / Chapter 6.3.2.3 --- Prescribing pattern of antibiotics in initial therapy --- p.114 / Chapter 6.3.2.4 --- Relationship between types and causes of change --- p.115 / Chapter 6.3.3 --- Appropriateness of antibiotic therapies --- p.117 / Chapter 6.3.3.1 --- Misuse of empirical therapy --- p.118 / INAPPROPRIATE USE OF ANTIBIOTICS IN LOWER RESPIRATORY TRACT INFECTION --- p.118 / INAPPROPRIATE USE OF ANTIBIOTICS IN SEPSIS --- p.120 / MISUSE OF CEFUROXIME --- p.122 / MISUSE OF THIRD GENERATION CEPHALOSPORIN --- p.127 / Chapter 6.3.3.2 --- Appropriate use of directed therapy --- p.129 / Chapter 6.3.3.3 --- Appropriate use of prophylactic therapy --- p.130 / Chapter 6.3.3.4 --- Excessive use of unclassified therapy --- p.131 / Chapter 6.3.4 --- Clinical outcome of treatment --- p.133 / Chapter 6.4 --- Conclusion --- p.134 / Chapter 7. --- Summary --- p.136 / Chapter 8. --- Recommendations --- p.140 / APPENDICES --- p.143 / Chapter 1. --- Usual adult daily dose range of antibiotics --- p.144 / Chapter 2. --- Assessment of indications and choices of agent of initial therapies in an audit of 324 antibiotic courses in a medical ward --- p.146 / Chapter 3. --- Culture test results in an audit of use of antibiotics in a medical ward --- p.160 / Chapter 4. --- Generic to trade name conversion of antibiotics --- p.163 / REFERENCES --- p.165