The Appropriateness of Empiric Treatment of Urinary Tract Infections in a
Tertiary Teaching Hospital in Joran: A Cross-Sectional Study
Authors : Rama Alkhawaldeh 1
, Rana Abu Farha 1
, Khawla Abu Hammour 2 and Eman Alefishat
Abstract : This is a cross-sectional study that was conducted at Jordan University Hospital (JUH) to evaluate the appropriateness of Urinary Tract Infection (UTI) empiric treatment based on microbial culture data and susceptibility testing. All urine cultures requested for adult patients (≥18 years) admitted to JUH within the period from January 2019–July 2021 were reviewed and only those cultures with positive episodes of infection were considered. In this study, 6950 urine culture episodes were screened; among them, 34.5% (n = 2400) revealed positive results. Among those patients with positive culture episodes, 1600 patients (66.7%) were discharged before the availability of culture results and were excluded. Of the remaining eligible 800 patients, 701 (87.6%) received empiric treatment. In 26.8% of the eligible cases (n = 214), the prescribed empiric agents failed to have appropriate coverage of the identified pathogens, and in 14.6% of the cases (n = 117) the identified microorganisms were reported as resistant to the prescribed empiric agents. Furthermore, only 13.4% of the patients (n = 107) were appropriately treated for their UTI with empiric antibacterial agents. We were not able to judge the appropriateness of UTI treatment for one third (n = 263, 32.9%) of the patients, because they did not have susceptibility reports performed. This study revealed an alarmingly high rate of inappropriate treatment of UTIs, which encourages the emergence of bacterial resistance and affects health-related outcomes negatively. Therefore, antimicrobial stewardship programs must be applied to optimize antibiotic consumption in hospital settings. View Full-Text
Keywords : antibiotic resistance; empiric antibiotic; urine culture; susceptibility test; Jordan
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Home delivery of medications: Community pharmacists' perspectives on the pros and cons of the service
Authors : Rana Abu-Farha1, Karem H. Alzoubi2,3, Rama Alkhawaldeh1, Rania Itani4, Samar Karout4, Tareq Mukattash3 and Eman Alefishat
Abstract : Objectives: The main goal of the current study was to investigate pharmacists' perception of home delivery of medications service in Jordan and their willingness to use the service.
Method: This cross-sectional observational study was conducted between March and April 2022. The study targeted community pharmacists working at different community pharmacies across Jordan. The study questionnaire was distributed through Facebook to target Jordanian community pharmacists' groups.
Results: Three hundred and twenty-four community pharmacists participated in the study, 75% (n = 244) of pharmacists reported being willing to use the home delivery and 274 (84.6%) thought it increases the efficiency of their community pharmacies' services. Only 129 (39.8%) pharmacists agreed or strongly agreed that unlike in-store service, home delivery of medications is suitable only for OTC but not for prescriptions medications Nearly half the number of participating pharmacists (n = 153, 47.2%) believe that the service is suitable for refill prescriptions but not for new prescriptions. Pharmacists believe that the foremost pros of the service were to continue life-saving medical treatment (n = 249, 76.9%), serve sick, elderly, and disabled patients (n = 241, 74.4%), and decrease congestion at health facilities (n = 228, 70.4%). On the other hand, the cons of this service, as perceived by pharmacists included failing to build a professional relationship with patients (n = 203, 62.7%), and the contribution to communication errors (n = 147, 45.4%). Logistic regression showed that pharmacists who serve 50 patients or more per day were more willing to use the service than those serving less than 50 patients per day (OR = 2.058, P = 0.032).
Conclusion: The majority of participating pharmacists in this study were willing to use the service at their community pharmacies, especially those serving a large number of patients per day which may indicate the potential of this service in relieving the pressure on community pharmacies and allowing them to serve more patients efficiently.
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