Antimicrobial resistance (AMR) has emerged as a major public health problem all over the world. Infections caused by resistant microbes fail to respond to treatment, resulting in prolonged illness and greater risk of death. This document focuses on
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the mechanism to develop a practically applicable hospital antibiotic policy and standard treatment guidelines (STG). In addition, the document contains information on various effective strategies for implementation of STG. It also discusses various activities and information required for the development of the antibiogram, antibiotic policy and standard treatment guidelines, such as surveillance programmes, the cause and controlling strategies for AMR and HAI; performance measures of antibiogram, antibiotic policy and standard treatment guidelines. A model hospital STG for community-acquired pneumonia in adults is included.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic
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use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicrobial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the popul
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ation” and that should therefore “be available at all times in adequate amounts”. However, there is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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AMR is one of the Key priority of the global health security agenda action package, as well as it is one of the commitments
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of Ministry of Public Health Afghanistan to combat AMR. In Afghanistan because of war and some other political issues the borders of the country are not well secured and well controlled therefore control of smuggling of medicine is a big challenge in front of the rational use of medicine. Lack of knowledge (professionals and public), poor economic state, conflict of war, presence of remote areas and etc…. are the other main challenges for this to won the battle of combating AMR.
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A practical manual - The book provides step by step guidance
to the process of rational prescribing, together with many illustrative examples. It teaches skills that are necessary throughout a cli
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nical career.
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This field study to assess the pharmaceutical situation was undertaken in Ghana in May-June 2008 using a standardized methodology developed by the World Health Organization. The study assessed medicines availability and affordability, geographical accessibility, quality and
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rational use among other issues. The survey was conducted in six regions. In each region, 6 public health care facilities, 12 private pharmacies and 1 warehouse were surveyed.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts
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of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care settings. It aims to rationalize the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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The objective of this book is to provide health workers with easily accessible information on important aspects of the medicines commonly used at primary care level in Zimbabwe. Medicines are a cruc
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ial part of the management of most of our patients, yet many medicines are potentially dangerous if not used correctly (by either prescriber or patient). It is important to have up-to-date information not only on the indications for, and the dose of a particular medicine, but also the contra-indications and reasons for special care, possible side effects and interactions with other medicine or medicines. The patient must also have information on how to use the preparation, what side effects may occur, and when to return for help.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these c
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ountries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Access to controlled medicines. 3rd edition
It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued care of children
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and adolescents with long-term conditions and diseases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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This document provides guidance on the application of non-pharmaceutical countermeasures to minimise the spread of the 2019 novel coronavirus (2019-nCoV) in the population. Some
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of the measures proposed refer specifically to certain phases of the epidemic (containment or mitigation phases), and can be adapted depending on the assessed severity/impact of the infection. Other measures are valid for all phases of an epidemic.
The guidance is based on the current knowledge of the 2019-nCoV and evidence available on other viral respiratory pathogens, mainly the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), the Middle East Respiratory Syndrome-related coronavirus (MERS-CoV) and seasonal or pandemic influenza viruses.
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For each medicine the Formulary provides information on use, dosage, adverse effects, contraindications and warnings, supplemented by guidance on selecting the right
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medicine for a range of conditions
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An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J Basic Clin Pharma 2015;6:109-14.
N95 or equivalent respirators are single-use personal protective equipment (PPE) designed for use by health workers that provide direct care to patients with diseases transmitted by aerosols or duri
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ng aerosol generating procedures (AGP) for patients with acute respiratory disease, as is the case of COVID-19. • Given the current shortage of N95 and equivalent respirators, the World Health Organization (WHO) has suggested the possibility of their extended use by the same individual for up to 6 hours or the reprocessing of respirators when necessary.
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A toolkit for pharmacists.
Emerging data show that medication errors and adverse events cause significant harm to patients’ health and
well-being. It is estimated that the burden of adverse events due to medicines is now comparable to that
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of
widespread diseases, such as malaria or tuberculosis.1 The impacts of medication errors also represent a
burden for health systems, with the annual cost associated with medication errors estimated at USD 42 billion
worldwideharm
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