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  1. 1
    Peer Reviewed

    Antibiotic use profile at paediatric clinics in two transitional countries.

    Palcevski G; Ahel V; Vlahovic-Palcevski V; Ratchina S; Rosovic-Bazijanac V

    Pharmacoepidemiology and Drug Safety. 2004 Mar; 13(3):181-185.

    In this study, we evaluated antibiotic utilisation pattern at two paediatric clinics in different European (transitional) countries: Croatia (Rijeka) and Russia (Smolensk). Antibiotic utilisation during the year 2000 was observed using the ATC/defined daily doses (DDD) methodology (ATC code-J01). Drug-usage data was expressed in numbers of DDD/100 bed-days and the DU 90% profile. In Rijeka, 35 different systemic antibiotics were used and in Smolensk 22. The overall consumption of antibiotic drugs in Rijeka was more than three times higher than in Smolensk (28.96 vs 8.3 DDD/100 bed-days). The top five antibiotic drugs used in Smolensk were amoxicillin, mydecamicin, ampicilin, doxycylin, gentamicin; and in Rijeka cefuroxime axetil, ceftriaxone, azytromycin, ceftibuten and amoxicillin. Differences in antibiotic prescribing patterns are greater than expected. The pattern of antibiotic utilisation in both countries implies that regional control measures and guidelines for antibiotic use in children should be urgently established. (author's)
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  2. 2

    [Drug management manual for primary healthcare facilities] Manuel de gestion des médicaments au niveau des formations sanitaires de base.

    Morocco. Ministère de la Santé. Direction des Hôpitaux et des Soins Ambulatoires. Division des Soins Ambulatoires

    [Rabat], Morocco, Ministère de la Santé, Direction des Hôpitaux et des Soins Ambulatoires, Division des Soins Ambulatoires, 2002 Mar. 44 p.

    This guide to drug management, prepared by the ministry of health of Morocco in the context of its policy aimed at improving the quality of care and services, constitutes a reference tool for sensitizing and training healthcare personnel. The goal in its development is to ensure access to medications, increasing their availability through a national strategy of acquisition and management of drugs and medical devices. The guide explains the notion of generic drugs, essential drugs and vital drugs; it outlines their streamlining through steps reflecting the pharmaceutical policy based on the concept of essential and vital drugs, the national list of which is one of the pillars; drug prescriptions; the fight against waste; information and education of patients about their proper use; and finally the control of the cycle of drug management whose basic functions are founded on four principles: selection, acquisition, distribution and utilization. The utilization of drugs as described by the guide involves rules to be observed for proper prescription, writing the prescription, dispensing medications and their use for the patient. The practical portion of the guide offers techniques for rational management of medications such as inventory management, order management and preventing loss. Indicators for tracking and evaluating consumption as well as information media are thus offered in order to permit those who make decisions about drugs to control drug management properly.
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  3. 3

    [Pharmaceutical and economic aspects of high blood pressure treatment in Morocco] Aspects pharmaco-économiques du traitement de l’hypertension artérielle au Maroc.

    Habbal R; Belaïche A

    Espérance Médicale. 2002 Oct; 9(87):540-544.

    In this article, the authors try to evaluate the scope of under-medication in the case of high blood pressure (HBP) in Morocco, and they attempt to evaluate certain pharmaceutical economic aspects of high blood pressure medication by utilizing the various data in the subject, as presented in tables. Analyses of these data showed the following elements: consumption of high blood pressure medication in Morocco remains quite low in comparison with the theoretical needs of the population, the consumption/need ratio, especially in private/pharmacy consumption corresponds to 2.3% of the needs of the population in HBP medication, a price analysis shows a sizeable variation in these values both between different families of high blood pressure medication and within a single family. The economic factor seems to be the primary obstacle to this consumption. An analysis of monthly costs for HBP treatment shows that they are relatively high, and represent on average, 11% of the Moroccan minimum wage. This chronic condition remains quite common, it affects a third of the adult Moroccan population. And despite the encouraging medical context, care of a hypertensive subject in Morocco remains unsatisfactory, all the more so given that generic antihypertensives remain modest in comparison with other drug classes. Not forgetting the absence of coverage by required health insurance and the relatively low purchasing power. In conclusion, the figures presented do not constitute an accurate image of the reality of consumption of these drugs in Morocco, but represent good indicators in order to allow this consumption to be monitored over several years.
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  4. 4

    Essential drugs and developing countries: a review and selected annotated bibliography.

    Mamdani M; Walker G

    London, England, London School of Hygiene and Tropical Medicine, Evaluation and Planning Centre for Health Care, 1985 Winter. 97 p. (EPC Publication No. 8)

    Many developing countries spend sizeable sums on the purchase of drugs yet an estimated 60-80% of their populations, particulary in rural areas, do not have constant access to even the most essential drugs. The provision of adequate amounts of effective drugs to treat the most important and common disease conditions is crucial if health services are to be effective and credible. Many problems are associated with the provision and utilization of therapeutic drugs in developing countries: inequitable access to cost-effective safe drugs; inequitable production and consumption with market concentration in the hands of a few multinationals encouraging competition based on product differntion and not price; escalating drug costs; inefficient procurement, distribution, management; and irrational prescription and consumption. To combat these problems, the essential drug concept was introduced by the WHO in 1977. In 1981, WHO established a special Action Program on Essential Drugs. This is a worldwide collaborative program that aims at urging member states to adopt national drug policies, as well as helping developing countries procure and use essential drugs. Several countries have implemented some of the suggestions of the Drug Action Program. Though some progress has been made towards achieving an increase in the use and availability of cost-effective drugs, very few countries have succeeded in decreasing the use of unsafe drugs and those of low cost-effectiveness. Effective legislation is a prerequisite to the effective use of drugs. Recommended action for governments of developing countries to involve the private sector include: creating incentive for increased domestice production; controlling promotional practices; and exerting price controls.
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