Cost Effectiveness of Six Drugs for the Treatment of Psuedomonas Aeruginosa Infections in Nigeria (original) (raw)
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Cost-minimization analysis of antimicrobial therapy in a tertiary healthcare institution in Nigeria
Journal of Pharmacy & Bioresources, 2010
Cost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant information such as diagnosis, cost of drugs (in Naira-N), dosage, duration of therapy among others were obtained retrospectively from patient case-notes for which antibacterial are the mainstay of therapy and dispensed prescriptions. The mean cost per defined daily dosage (DDD) of generic and branded for each antibacterial was computed. These were compared using Student's t-test. The outcome measure was potential eradication of bacterial in question by the respective antibacterial drug. The analyses showed that the use of expensive branded drugs were very rampant even when the much cheaper generic equivalent is available. The differences in the mean cost/DDD were very significant for all the antimicrobial agents at p<0.05. For example the mean cost/DDD of ciprofloxacin was N267 for branded product and N80.00 for generic (t = 421.2 at p<0.05).Sensitivity analysis also Confirm this decision. Prescriptions of expensive branded drugs were rampant even when the much cheaper generic equivalents are available. The mean cost per Defined Daily Dose of Branded and Generic equivalent were significantly different for all antibiotics applicable for cost minimization analysis, with Generic Products much cheaper than Branded equivalent.
Pseudomonas aeruginosa Infections in a Tertiary Hospital in Nigeria
African Journal of Clinical and Experimental Microbiology, 2014
Background: Pseudomonas aeruginosa is a known opportunistic pathogen frequently causing serious infections. It exhibits innate resistance to a wide range of antibiotics thus causing high rates of morbidity and mortality worldwide. Objective: This study was done to determine the distribution and the antibiotic susceptibility pattern in clinical isolates of Pseudomonas aeruginosa in NHA. Method: Laboratory data on 265 Pseudomonas aeruginosa isolates from a total of 30,384 clinical specimens processed over a 3 year period (January 1st 2010 to December 31st 2012) were analyzed. Results: A total 30,384 samples were submitted for bacteriologic analysis, 265 (1%) yielded Pseudomonas aeruginosa of which 195 (74%) were from in-patient sand 70 (26%) fromout-patients.185 (70%) isolates were from adults while 80 (30%) were from children. 87% of the isolates were susceptible to imipenem, 77% to amikacin, while 34% were resistant to ciprofloxacin and 46% resistant to ceftazidime. Conclusion: The relatively high proportion of resistance to ciprofloxacin and ceftazidime, and the emerging resistance to amikacin and imipenem are worrisome and calls for rational antibiotic use and institution of effective resistance surveillance and infection control measures. .
2018
Background: Microorganisms are readily transmitted through various means including contaminated materials or instruments used in patient care. Disinfection is an important component of infection control. Use of chemical disinfectant has led to drastic reduction in transmission and spread of hospital pathogens. Concentration has a great influence on the potency of disinfectants. An evaluation study to determine the effectiveness of in-use dilutions of common disinfectants used in the University of Calabar Teaching Hospital on Pseudomonas aeruginosa strains was carried out. Method: P.aeruginosa isolates were obtained from inanimate sources in the hospital and characterized with a Gram Negative-ID system using P.aeruginosa ATCC 27853 as control. In-use dilutions of four disinfectants, Dettol, izal, savlon and bleach, were obtained from house-keeping staff in the hospital wards. The Rideal-walker phenol coefficient test was used to determine disinfectant efficacy while thequantitative s...
International Archives of BioMedical and Clinical Research, 2017
Background: The increasing trend of multi-drug resistant Pseudomonas aeruginosa implicated in most nosocomial infections in Nigeria has necessitated this present study; which investigated the resistance and susceptibility patterns of P. aeruginosa isolated from hospitals in Onitsha, Southeast Nigeria. Methods: A total of 22 clinical and environmental isolates of P. aeruginosa were recovered from 10 hospitals in Onitsha, Southeastern Nigeria and they comprised 3 (13.6%) isolates from hospital sinks, 2 (9.1%) from hospital mops, patients' table, trolleys, sphygmomanometer, laboratory work bench and cleaning buckets respectively and 1 (4.5%) from theatre bed, wound swab, nasal swab, nurses' tray, floor, disinfectant and ear swab respectively. Antimicrobial susceptibility testing for 11 antibiotics was performed by agar disk diffusion on Muller-Hinton agar plates and multiple antibiotic resistance index (MARI) was also determined. Results: Antibiogram categorized the 22 P. aeruginosa isolates into 5 different antibiotypes. Results showed that each isolate was resistant to ≥ 3 classes of antibiotics; 3 (13.6%) were resistant to 7 antibiotics; 11 (50%) were resistant to 8 antibiotics; 5 (22.7%) were resistant to 9 antibiotics and 3 (13.6%) were resistant to 10 antibiotics. Susceptibility testing showed that all the 22 isolates were multi-drug resistant being resistant to at least 3 classes of anti-pseudomonal drugs. P. aeruginosa had highest resistance rates to the cephalosporins (ceftazidime, cefuroxime, cefotaxime, cefepime) at 100%, followed by piperacillin (100%), amoxicillin-clavulanic acid (100%) and tetracycline (100%). The multi-drug resistance (MDR) rate was determined at 100%. Highest number of susceptible isolates was recorded for imipenem (100%) and amikacin (86.4%) respectively. Conclusion: The high resistance profiles observed in this study could limit available therapeutic options for infections caused by these multidrug resistant strains if they are not properly detected and reported by hospital laboratories.
Antimicrobial susceptibility of Pseudomonas aeruginosa strains in Bamako, Mali
2021
Pseudomonas aeruginosa is generally susceptible to antibiotics of the families of Beta-lactam, aminoglycosides and quinolones. The aim of this study was to evaluate the antimicrobial susceptibility of P. aeruginosa strains in Bamako, Mali. P. aeruginosa strains were isolated on Drigalski agar. Antimicrobial susceptibility testing was performed using the disc diffusion method on Mueller-Hinton agar. Among 317 non repetitive strains recovered from 2010 to 2019, there were 246 (77.6%) hospital strains and 71 (22.4%) extra-hospital strains. Colistin (100%), imipenem (98.4%), ceftazidime (89.3%), amikacin (85.2%) and piperacillin (72.3%) were the most active antibiotics against our P. aeruginosa strains. Of the strains 11 (3.5%) were multi-drug resistant (MDR) and 5 (1.6%) were extensively drugresistant (XDR). The extra-hospital P. aeruginosa strains were more susceptible to aztreonam (91.5% vs 60.6%; P = 0.0000018), piperacillin (84.5% vs 68.7%; P = 0.013), gentamycin (84.5% vs 62.2%; P = 0.00071), netilmicin (56% vs 32.5%; P = 0.0045) and ciprofloxacin (79% vs 65.4%; P = 0.0455) than the hospital strains. Colistin, imipenem, ceftazidim, amikacin and piperacillin have a high-level activity against P. aeruginosa in Bamako.
Hospital economic impact of an outbreak of Pseudomonas aeruginosa infections
Journal of Hospital Infection, 2009
A total of 67 patients involved in an outbreak of Pseudomonas aeruginosa in the intensive care unit (ICU) were retrospectively followed to determine whether case patients experienced differences in cost, length of stay and survival rates when compared with non-affected patients. The method of microcosting, a technique that involves detailed identification and measurement of all care items and services offered by the hospital, was used to identify attributable costs related to diagnostic procedures, pharmacy and ICU stay of each patient. Seventeen patients developed nosocomial P. aeruginosa infection. On average, these patients incurred adjusted hospital costs of V27,917, 66% higher than non-case patients (P ¼ 0.002). The extra length of ICU stay attributable to P. aeruginosa infection was 70 days (P ¼ 0.0001). In multiple linear regression analysis, we found that P. aeruginosa infection was an independent predictor of increased hospital costs and length of hospital stay. On the basis of these findings, a conservative estimate of the extra cost attributable to P. aeruginosa infection in our ICU was V312,936 (95% confidence interval: 305,676e320,196).
Multidrug resistant Pseudomonas aeruginosa from Southwest Nigeria hospitals
2012
Pseudomonas aeruginosa remains one of the most dreaded resistant pathogens mostly encountered in infections worldwide. However; serious infections due to this bacterium are predominantly hospital-acquired. This present study is aimed at investigating the resistance patterns and susceptibilities of P. aeruginosa isolated from hospitals in Southwest Nigeria. A total of 54 unrelated clinical strains of P. aeruginosa isolated from 5 hospitals in Southwest Nigeria comprises of 38.9% isolated from urine, 20.4% from wounds, and 11.1% from pus while the remaining 29.6% were distributed among other clinical sites. Antimicrobial susceptibility testing for 21 antibiotics and minimum inhibitory concentration (MIC) was done by disk diffusion and E-test method respectively. Each isolate was resistant to ≥ 3 classes of antibiotics, 24 (44.44%) were resistant to 4 ̶ 9 antibiotics; 17 (31.48%) were resistant to 10 ̶ 13 antibiotics; 11(20.37%) were resistant to 14 – 16 antibiotics and 2 (3.70%) were ...
International Journal of Health Research
Purpose: To carry out economic evaluation of antibacterial usage for Ear, Nose and Throat infections in a tertiary health care facility in Nigeria. Methods: Antibacterial utilisation evaluation was carried out retrospectively over one year period by reviewing 122 case notes containing 182 prescriptions of patient with Ear Nose and Throat infections. Relevant data including demographics, diagnosis, prescribed drugs, dosages, were extracted and the associated costs analysed. Results: Highest prevalent rate of Ear, Nose and Throat infections occurred in children under 10 years of age (59.3%) with otitis media predominating (45.0%). Average antibacterial cost per case was N1971.37 (US$15.16). Penicillins were the most frequently prescribed (35.5%) at a cost of N89,468.00 (US$688.22) representing 24.9% of the total antibacterial cost. Cephalosporins were used at a rate of 12.1% with a percentage total antibacterial cost of 48.4% (N173,554.00, US$1335.03). Conclusion: The average cost of antibacterial agents to patients studied is high. This call for prudent use of these agents which should be evidence based and closely monitored.
Tropical Journal of Pharmaceutical Research, 2011
Purpose: To evaluate the cost of antibacterial usage to patients in a tertiary health facility in Nigeria. Methods: Drug utilization evaluation was carried out retrospectively among patients with sexually transmitted infections (STIs) over a one-year period between 2005 and 2006 in Lagos University Teaching Hospital (LUTH), Nigeria. Case notes numbering 230 and containing 317 prescriptions were sampled consecutively with the aid of diagnostic coding cards. Relevant data including case demographics, diagnosis, prescribed drugs, and dosages were extracted and the associated costs analysed. Results: A majority of the patients (82.3 %) were youths aged 21-40 years. Higher prevalence was observed among male patients (70.2 %). The proportion of drugs prescribed in generic and branded names were 82.1 and 17.9 %, respectively. Total number of antibacterial doses was 7284 at a total cost of NGN239,420.00 (US$1,841.69). Average antibacterial cost per patient was NGN1,040.96 (US$8.00). Quinolones were the most widely prescribed class of antibacterial agents (31.1 % of cases) at a cost of NGN81,646.00 (US$628.05) representing 34.1% of the total antibacterial cost to patients. Conclusion: This study indicates that antibacterial cost was high, relative to the purchasing power of the local populace, a large proportion of whom live below the poverty line (US$1.00 per day). Furthermore, a greater proportion of the antibacterial cost was due to a few agents, the use of which should be evidence-based and closely monitored.
Abstract Background: Multiple antibiotic resistance in bacteria populations is currently one of the greatest challenges to the effective management of infections. Constant bacteriological monitoring of pathogens in the hospital in general and specialized units is necessary to provide accurate data on the prevalence and antibiotic resistance pattern of specific pathogens. Method: All clinical samples from the surgical units of ABUTH, Zaria over a 24-month period were processed and Pseudomonas aeruginosa isolates characterized and identified using standard microbiological procedures. The antibiotic susceptibility of isolates and a standard strain to ceftazidime, amikacin, gentamicin, imipenem, ciprofloxacin and perfloxacin was determined by the disk diffusion method. Results: A total of 1,452 clinical specimens were processed and 878 pathogenic bacteria isolated within the study period. There were 92 Pseudomonas aeruginosa isolates, giving a prevalence level of 10.5%. Most of the isolates were from urine (51.1%) and wounds (41.3%). A total of 18/92 (19.6%) of the isolates were resistant to three or more of the antibiotics tested, with the most prevalent resistance pattern being ceftazidime+gentamicin+perfloxacin+ofloxacin (27.8%). Conclusion: There is need for instituting an antimicrobial resistance surveillance system that provides clinicians with up-to-date data on the prevalence and resistance pattern of commonly encountered pathogens like Pseudomonas aeruginosa. Key words: Psuedomonas aeruginosa, drug resistance, surgical units