万古霉素的药物利用评价标准的建立

目的：建立万古霉素药物利用评价标准（DUE）,优化临床用药的安全性和有效性。方法：采用回顾性分析方法收集某院2017-2018年使用万古霉素的住院患者病例,参照国内外的药物利用评价标准,通过对患者的用药情况和血药浓度监测结果的分析,建立严格的DUE标准评价万古霉素使用的合理性。结果：在196例患者中,用药指征、用法用量、药物相互作用等方面存在不合理现象,用药指征符合率为27.5%,用法、用量及疗程符合率为52.0%,药物相互作用项目的符合率为33.1%。有97例患者进行了治疗药物监测,谷浓度达标率（10~20 mg·L^-1）为42.3%。结论：开展万古霉素药物利用评价,有利于提高万古霉素用药的合理性,改善患者的临床结局。     

Drug allergy diagnosis in humans: possibilities and pitfalls

Due to the potential hazards of drug allergies, an early and reliable diagnosis is crucial. The use of in vivo tests is not recent but, because of the hazards of skin testing in patients with a history of anaphylaxis, they had been abandoned for a while. Recent reevaluations have shown that for some drugs, e.g. antibiotics-reliable skin tests can ensure the diagnosis of drug allergy in up to 70% of cases. Many in vitro tests based on well-defined mechanisms, e.g. the basophil degranulation test have been used for the diagnosis of totally unrelated allergic mechanisms. It is almost impossible to interpret their validity as diagnosis tools. Nevertheless, other tests, e.g. the lymphocyte transformation test which have been evaluated in well-conducted recent studies, seem to have a good predictive value. Their use is still restricted to clinical trials or research studies. A reliable clinical approach as well as a detailed examination of the drug intake remains obligatory to diagnose drug allergy. Available in vivo and in vitro tests are sometimes used to confirm the diagnosis. The sensitivity and specificity of these tests is evaluated in clinical studies. Research to improve the existing tests and to develop new diagnostic tools is still of paramount importance.     

Drug utilization and expenditure of anticancer drugs for breast cancer

PurposeDrug utilization studies have proven to be an effective tool in the evaluation of rational drug use in different health care systems, including oncology. The drug utilization studies were used in many institutes to ensure the safe, effective and appropriate use of drugs being prescribed. The main aim of this study was to assess the utilization pattern of anticancer drugs in breast cancer patients.MethodA retrospective cross-sectional observational study was carried out at King Saud University Medical City (KSUMC) for 1 year from January 2016 to December 2016. All female patients diagnosed with breast cancer during this year were included in the study.ResultsA total of 101 patients were included in this study. Most patients received an average of three anticancer drugs. The most commonly prescribed medication was fluorouracil, epirubicin, and cyclophosphamide (FEC) regimen, which was used in 81% of patients. Combinations of FEC + docetaxel and FEC + docetaxel + trastuzumab were received by43% and 23% of patients, respectively. Docetaxel was the most commonly used drug in neoadjuvant setting, whereas letrozole and trastuzumab were prescribed more frequently in hormonal and targeted therapies, respectively. The total drug expenditure on anticancer therapy was approximately 3.8 million Saudi Riyals (S.R), with adjuvant therapy constituting over half of the total spending. In neoadjuvant settings, the spending cost for hormonal therapy was the highest. The condition of most breast cancer patients was improved during the study period, whereas only 29% of the included patients progressed.ConclusionFEC was the most common regimen used in this study, consistent with the National Comprehensive Cancer Network (NCCN) guideline recommendation. Our results indicated that adherence to a clinical guideline and recommended medication regimens improved patient outcomes. Our finding indicate how analyzing drug utilization pattern could benefit institutions in managing inventory and efficiently using health care resources.     

Drug utilization of selected pharmacotherapeutic groups

A single orientational survey investigated the consumption of antiepileptic, antihypertensive and vasodilating agents. The analysis aimed to investigate the effect of the factors of sex and age patients as to the requirements for drugs of the selected pharmacotherapeutic groups. Evaluation of the results was performed on the basis of statistical processing by means of the test of the difference of two relative values. A dependence of drug consumption on the above-mentioned identification characteristics was confirmed, high consumption of antihypertensive and vasodilating agents, particularly in higher age categories, was demonstrated. The results have shown that it is necessary for our health service to continue considering the growing trend of drug consumption and not only to record, but also to analyze the consumption and its assortment and to use the conclusions both in practice and theory of pharmacotherapy.     

Drug utilization research in clinical practice

This report describes the use of drug utilization studies in clinical practice, with special emphasis on future developments. It has been shown that pharmacy services affect prescribing patterns, have great potential for reducing health care costs, and are in a position to produce financial savings in drug therapy and drug use. However, it is essential to balance the drug utilization figures against the resulting outcome, and attention should be focused on the assessment of therapeutic results. To make therapeutic result assessment possible, end points need to be defined. Several examples of such end points are given and include incidence of nosocomial infections and postoperative wound infections. New parameters have been established to assess the severity of the illness and to follow the effect of drugs on the disease process in the form of an Index of Disease Activity (IDA). IDAs have been prepared for Crohn's disease, rheumatoid arthritis, and ankylosing spondylitis. It then becomes possible to link drug utilization data with a drug's influence on a disease, making drug utilization research a recognized discipline within the medical field.     

Drug regulation in South Africa

South Africa has a population of approximately 30 million people. The country has a mixture of advanced industrial and rural economies, but the medicine control system is consistent with similar systems established in the major industrial countries of Western Europe and North America. Because most of South Africa's population lives in conditions more closely akin to the developing world than to the Western nations, it is important to examine whether the country is optimally served by this drug regulation model and to define critically the strengths and limitations of the established system. The conclusions might be relevant for other countries at a comparable stage of development.     

Drug utilization study of antiepileptics in Hungary

This paper describes drug utilization review activities on anticonvulsant drugs in Hungary. Data on the use of phenytoin, carbamazepine, primidone, and sulthiam in the 20 administrative regions of the country are presented. From 1971 to 1980, consumption of these anticonvulsants doubled, and most of them were used in combination therapy. Estimates of the numbers of epileptics in the country were calculated from data on the international incidence of epilepsy and from total drug consumption data in Hungary.