E-DRUG: Co-trimoxazole prophylaxis for HIV in children (3)
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Dear Murtada
I see your point. I think the situation depends very much on
the economic environment, affordability of the medication, counselling of
parents and the astuteness and clarity of pharmacists and dispensers.
I have experience of dispensing antibiotic powder and granules for
reconstitution as suspensions and liquids both in Ghana and the United Kingdom. Both
in the hospital setting and in community
In Ghana most of the time parents have had to buy medications for their
children and the expiry date is before the reconsituted contents in bottle run
out but before the end of the course of therapy. Depending on the affordability
of the medications and the financial capacity of these parents they may or
may not come and buy more of the mediaction for their kids. I suppose the
national health insurance scheme will address these situations when fully in
place.
In the UK where most patients who will be having antibiotic
liquids/suspensions dont pay for their prescriptions the main factor for avoiding patients
continuing to use a reconstituted antibiotic beyond their expiry is explicit
counselling by the pharmacists and/or dispensers. My experience tells me that
in such cases patients adhere fully to the instructions given by the
pharmacist.
Parents are given a choice of reconstituting the antibiotic liquids
themselves when it runs out or come back to the pharmacy for more of the
recconstituted medication.This will depend on how the confident patients feel about
reconsitution based on the instruction they will hav been given.
In hospitals however pharmacists have more of a chance to monitor and
control these situations so there should be no problem.
Thanks
alfred sackeyfio MRPharmS
(Pharmacoeconomist)
07713 250 929
Awnsack@aol.com