With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
Anti-Bacterial Agents ; China ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Drug Utilization Review ; methods ; statistics & numerical data ; Geography ; Hospitals ; classification ; statistics & numerical data ; Humans ; Inpatients ; statistics & numerical data ; Outpatients ; statistics & numerical data

The theory of rough sets has been applied to evaluate the importance of each herb in the Chinese herbal compounds in this study. This method could distinguish core herbs through different syndrome types in the same class of prescription by measuring the importance of attributes. Compared to the frequency statistical method, the rough sets method could reveal law of compatibility in categorized formula more deeply. This study gives some guidance to clinical application of herbs and the drug screening in the development of new Chinese traditional medicine.
Decision Trees ; Diagnosis, Differential ; Drug Prescriptions ; statistics & numerical data ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Medicine, Chinese Traditional

OBJECTIVETo analyze the relationship between TCM's characteristics and treatment of cardiovascular diseases on the basis of the modem medical research literatures about treatment of cardiovascular diseases and establish a mathematic model in order to give reference for clinical study and clinical prescription for treatment of cardiovascular diseases with TCMs.

METHODArticles on treatment of cardiovascular diseases with TCMs published at home in the past 20 years were collected and screened to summarize the number of TCMs with different function, property, flavor, channel tropism and the number of them with the therapeutically effect on cardiovascular diseases. And a mathematic model was established on the multivariate discriminatory analysis.

RESULTMedicines for activating blood circulation and removing blood stasis (21.21%), those restoring deficiency (17.65%), those attributive to heart channel (21.82%) and those attributive to spleen channel (16. 11%) were relatively active in study for treatment of cardiovascular diseases and showed great difference (P < 0.05). According to findings of the logistic regression screen, TCMs attribute to heart, spleen, gallbladder, pericardium channel and those restoring deficiency were important impact factors with therapeutically effect on cardiovascular diseases (regression coefficient > 0 and P < 0.05). The coincidence was 91.6% between mathematical computing and original classification, indicating the coincidence with relevant theories of the traditional Chinese medical science.

CONCLUSIONA more objective Logistic regression equation with a higher accuracy rate of retrospective inspection is established to detect the effect of TCMs with different characteristics on cardiovascular diseases. It is suggested that more experiments and clinical comparative studies on treatment of cardiovascular diseases with TMCs shall be included in pharmacopeia.

Cardiovascular Diseases ; drug therapy ; Drug Prescriptions ; statistics & numerical data ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Logistic Models ; Multivariate Analysis

To analyze the medication regularity of traditional Chinese medicine(TCM) prescriptions for gastropyretic excessiveness diabetes recorded in Chinese Medicine Prescriptions Dictionary. A total of 103 eligible prescriptions were input into the system platform, and the Apriori algorithm was used to analyze their medication regularity. The 103 prescriptions for gastropyretic excessiveness diabetes were selected from the system, and 29 herb medicines were found with frequency of usage more than 8. Totally 33 commonly used herbal pairs(support degree≥10), twenty-three 3-herb core combinations(support degree≥8, confidence values≥0.5), and twenty-one 4-herb core combinations(confidence values≥0.5) were discovered after the medication regularity analysis by Apriori algorithm. The herbal medicine combinations with the highest correlation degree were discovered after the association rule analysis on the 103 prescriptions(support degree≥10, confidence values≥0.5). The four properties, five tastes, channel distributions and frequency of dose of the 103 prescriptions were also obtained after the corresponding analysis. According to the analysis and summary of the above data, the combination of Trichosanthis Radix, Anemarrhenae Rhizoma, Coptidis Rhizoma and Ophiopogonis Radix could reflect the medication regularity of TCM prescriptions for gastropyretic excessiveness diabetes to a certain degree, which is of great significance in guiding value in clinic.
Data Mining ; Diabetes Mellitus/drug therapy* ; Drug Prescriptions/statistics & numerical data* ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Medicine, Chinese Traditional

OBJECTIVES: To review the drug prescription pattern of antiulcerative agents for elderly inpatients. METHODS: The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1994. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription. Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. RESULTS: The number of patients prescribed antiulcerative agents was 1,059 (64.9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by H2 antagonist (16.0%). Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the total omeprazole prescriptions. CONCLUSIONS: Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulcerative agents.
Aged* ; Busan ; Cimetidine ; Cohort Studies ; Diagnosis ; Diazepam ; Drug Interactions ; Drug Prescriptions ; Drug Utilization Review* ; Drug Utilization* ; Drug-Related Side Effects and Adverse Reactions ; Female ; Hospitals, Community ; Humans ; Inpatients* ; Insurance ; Korea ; Male ; Omeprazole ; Prescriptions ; Statistics as Topic

OBJECTIVETo our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students.

METHODSA cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences.

RESULTSA total of 328 forms were completed. Of these, 264 (80.5%) homeopathic undergraduate students admitted of prescribing medicines independently and most (40.5%) said that they did this 2-3 times a year. The most common reasons for this were 'urgency of the problem' (35.2%), 'previous experience with same kind of illness' (31.8%), and 'the problem too trivial to go to a doctor' (25.8%). About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital (odds ratio = 5.8; 95% confidence interval 2.247-14.972). Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses.

CONCLUSIONPrescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.

Adult ; Cross-Sectional Studies ; Drug Prescriptions ; standards ; statistics & numerical data ; Female ; Homeopathy ; education ; manpower ; standards ; Humans ; India ; Male ; Students ; statistics & numerical data ; Surveys and Questionnaires ; Young Adult

With the imformation technology getting a great progress in recent years, the modem imformation technology is extensively employed in the study of traditional Chinese medicine (TCM) prescriptions. In this article a summary is given, which includes applications of modern imformation technology in the study of TCM presciptions. It focus on the introduction of the databse technology, data-mining technology and chemometrics, and brief virtual screening technology, experimental design, innovation design, study of complexity and bioinformatics technology, all of which deployed in the study of TCM presciptions, so as to enligten researchers on modernized study of TCM prescription and its development in the future.
Databases as Topic ; statistics & numerical data ; Drug Combinations ; Drug Information Services ; statistics & numerical data ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Humans ; Medicine, Chinese Traditional ; methods ; Plants, Medicinal ; chemistry ; Prescriptions ; statistics & numerical data ; Quantitative Structure-Activity Relationship ; Software

BACKGROUNDMedical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015.

METHODSWe collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/defined daily doses system was used to evaluate the rationality of antibiotic use.

RESULTSOver the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicillin and clavulanate potassium dispersible tablets (7:1) and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals.

CONCLUSIONSAntibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.

Adolescent ; Adult ; Age Distribution ; Aged ; Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; therapeutic use ; China ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; Hospitals, General ; Humans ; Middle Aged ; Outpatients ; statistics & numerical data ; Young Adult

BACKGROUNDChanging health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.

METHODSA 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.

RESULTSA total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.

CONCLUSIONChange of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.

Adult ; Continuity of Patient Care ; Databases, Factual ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; Female ; Health Personnel ; Humans ; Logistic Models ; Pharmaceutical Preparations ; Pregnancy ; drug effects ; Saskatchewan ; United States ; United States Food and Drug Administration

BACKGROUNDDepression is often comorbid with chronic somatic diseases. Few previous studies have investigated the prevalence of somatic diseases in depression or the prescription pattern of antidepressants in comorbidly depressed patients in Asia. This study aimed to investigate the prevalence of somatic comorbidity (SC) in depression and compared the prescriptions of antidepressants in depressed patients with and without SC.

METHODSA total of 2320 patients treated with antidepressants in 8 Asian countries were examined, and a diagnosis was based on the International Classification of Disease, 10 th revision. We listed 17 common chronic somatic diseases. Patients' socio-demographic and clinical characteristics and psychotropic drug prescriptions were recorded using a standardized protocol and data collection procedure.

RESULTSOf the patients examined, 1240 were diagnosed with depression and 30% of them (n = 375) had SC. The most common comorbid condition was diabetes (23.7%). The patients with SC were more likely to seek help at a general hospital (74.7% vs. 47.2%), and had a higher incidence of symptoms involving sadness, disturbed sleep, and poor appetite. Noradrenergic and specific serotonergic antidepressant was prescribed more for patients with SC than for those without SC (30.4% vs. 22.9%).

CONCLUSIONSSC is common in depressed Asian patients. It is important to strengthen the recognition of depression, especially in general hospitals and when patients report some somatic discomfort. It is also a matter of urgency to establish evidence-based guidelines for the use of new antidepressants in depressed patients with SC.

Adult ; Antidepressive Agents ; therapeutic use ; Asia ; Asian Continental Ancestry Group ; Depression ; drug therapy ; epidemiology ; Drug Prescriptions ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Prevalence