Thesis (Msc.(Med.)(Pharmacy))--University of Limpopo, 2010 / Background
Information regarding disease epidemiology, treatment options and emerging infections and
resistance constantly challenge the knowledge of the health care practitioner. Antibiotic prescribing
patterns was identified by the Dr George Mukhari hospital antibiotics committee as an area of concern.
Due to this concern it was decided to investigate the prescribing patterns in adult patients with
meningitis admitted to the internal medicine wards at Dr George Mukhari hospital.
Objectives
To determine the current antimicrobial prescribing patterns in adult patients diagnosed with meningitis,
to record the causative organisms and sensitivity patterns, to record the outcom e, cost and length of
treatment.
Method
Patient and prescriptions data were recorded prospectively on specially designed data sheets from
five internal medicine wards for four months (May to August 2008). Patients were followed until
discharged.
Results
Sixty-six patients were enrolled; 41 recovered, 22 died, 2 refused treatment and 1 absconded.
Ceftriaxone was prescribed the most frequently and was administered to 58 patients; four patients with
confirmed cryptococcal meningitis received amphotericin B IVI, three patients were started on
iv
Rifafour® for suspected tuberculosis meningitis and one was started on cefuroxime. Specimens from
only 22 patients were sent for culture and sensitivity tests; ten were positive for yeast-like organisms,
three for S pneumoniae and one for N meningitides and tuberculosis respectively.
The average duration of treatment of patients with meningitis was 9.2days. The total cost of antiinfectives
used for treatment of meningitis amounted to R111, 292.53 and the average cost per patient
was R1 686.25. The cost of all medicines prescribed for the 66 patients amounted to R116, 490.43.
Conclusion
Ceftriaxone was used frequently as empiric therapy. Specimens for culture and sensitivity were not
sent routinely. Therefore it was difficult to monitor and observe any resistance patterns and to contain
cost of treatment.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/219 |
| Date | January 2010 |
| Creators | Grootboom, Wandisile M |
| Publisher | University of Limpopo (Medunsa Campus) |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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