[e-drug] Out Patient Parenteral Antimicrobial Therapy (cont'd)

e-drug
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E-drug: Out Patient Parenteral Antimicrobial Therapy (cont'd)
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Hi All,

Atieno has raised a very interesting issue. The use of highly effective
Antibiotics to manage moderate to severe infections in an out-patient
basis for health economics reasons is acceptable to most
practitioners. When I was working for Pfizer in Nigeria, we made
those arguments for the use of oral Azithromycin in paediatric acute
respiratory infections. For injectable antibiotics, I have more
concerns.

In Botswana, we use stat dose Ceftriaxone in the syndromic
management of STD. I had opposed this numerously because that
practice alone has accounted for about 80% of out-patient injectable
drug use in my hospital. It is my believe that parenteral antibiotics are
only indicated when oral equivalents are not available, patients can
not swallow, has acute GE with V&D, etc.

I will not want to encourage OPAT because it will lead to
indiscriminate injection use with the attendant risks in the developing
countries.

Jude Nwokike
B.Pharm, MSc.Pharmacology
MPH student MEDUNSA
Maun General Hospital
P.O.Box 12, Phone 00267 6865005
Maun. Rep of Botswana.
Email: monkiyke@yahoo.com
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E-DRUG: Out Patient Parenteral Antimicrobial Therapy (cont'd)
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I will not want to encourage OPAT because it will lead to
indiscriminate injection use with the attendant risks in the
developing countries.

Jude Nwokike's warning about the differences in health systems and
health practices between industrialised countries and developing nations
is certainly relevant and one would need to consider what problems might
arise in each particular setting (and the resources required to manage
them). One must also bear in mind that the costs of health care also
differ considerably such that whilst OPAT may be shown to be
cost-effective in European countries, for example, it does not
automatically follow that it is cost-effective in an African country
scenario.

Regards

Douglas Ball

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E-DRUG: Out Patient Parenteral Antimicrobial Therapy (cont'd)
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Dear Dr. Douglas,

I am very much agree with your statement as health system differ with differ
in economic system, as for example Indian Heath System differ from European
countries Health System.
The viability of the concept is not much in Indian scenario as well as
African countries because of its economic situation.

with best regards

Amit Jain
IIHMR, Jaipur
India
Email: amit_india2004@yahoo.com
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