• Title/Summary/Keyword: side effects of antibiotics

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A Study on Prescription and Management of Medicines by School-Nurses (양호교사(養護敎師)의 투약(投藥) 및 의약품관리(醫藥品管理) 실태(實態))

  • Kim, Jung Hee;Park, Jae Yong;Cha, Byung Jun
    • Journal of the Korean Society of School Health
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    • v.11 no.2
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    • pp.297-307
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    • 1998
  • The purpose of this paper is to understand the prescription and management of medicines by school-nurses. A survey was mailed to 199 school-nurses in elementary and secondary schools in Pusan from February 10 to March 31, 1997. It was shown that 97.0% of the schools have visiting school-doctors and only 29.6% have visiting school-pharmacists. 36.7% of the respondents don't know the amount of this annual health-related budget. Concerning the annual budget of purchasing medicines, 50.4% of the elementary schools spend 210,000 won to 400,000 won and 45.0% of the secondary schools spend more than 610,000 won. 56.3% of the respondents said the budget was enough, but 5% said it was not. 70.9% of the schools purchase medicines twice a year. The average number of students visiting the nurse in a year are 1,892 in elementary schools, 1.6 times per student and 2,471 in secondary schools, 1.7 times per student, respectively. The annual average number of students who were prescribed medicine a year are 1,804 in elementary schools, 1.5 times per student, 2,372 in secondary schools, 1.7 times per student. The percentage of students who are prescribed internal medicines was 45.5% in elementary, schools and 61.3% in secondary schools, respectively. To the preralence sicknesses, the wound was the most common, accounting for 42.7% in elementary and 22.6% in secondary schools. Next was abdominal pain, indigestion, and headaches in elementary schools; and colds, indigestion, and abdominal pain in secondary schools, respectively. To the dirersity of medicines prescribed: internal medicines 29 for abdominal pain, 25 for indigestion, 8 for physiological pain, 13 for headaches, 30 for colds, and 10 for eye disease; external medicines 2 for skin disease, 10 for toothaches and 31 for other sicknesses. 42.7% of the respondents said the schools have enough medicines, but 7.6% said that schools need more. 50.8% of the respondents said they get information on medicines from TV advertisements or medicine-related books, 16.6% get information from visiting pharmacists. More experienced nurse-teachers are likely to get information from visiting pharmacists, but 37.5% of the respondents who have less then four year experience in school get information through other nurse-teachers before deciding to buy medicines. To the choice of medicines: 83.9% of the respondents said that they choose safe medicines with less side-effects. 40.7% responded that they write down the prescription history daily, but 6.1% said they do this only once in two or three months. To the confidence in prescriptions, 37.7% of the respondents said they are sure of the effectiveness of the medicines they prescribe. To what extent the nurse-teachers prescribe, 50.3% said they prescribe to the level of anagelics, and 21.1% prescribe to anti-histamines and antibiotics. 80.4% said that the details of illnesses and medicines to be prescribed in school should be regulated by a school health-care law. To the problems in prescription, 79.9% of the respondents worry about abuse by students who want prescriptions but have no serious illnesses, 57.8% worrg about the lack of information on medicines and dosage. And 55.8% said they can't tell the difference between medicines whose brands are different, but bare the same ingredients. The conclusion of this study is that a health education program is necessary to prevent the misuse or abuse by students and a continuing education program for school-nurses is needed to solve the problems related to the purchasing and prescription of medicines. The criteria of the prescription of medicines also should be regulated by a school health-care law or management acts.

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The Effect of Low-dose Longterm Erythromycin on Bronchiectasis (기관지확장증에서 Erythromycin의 소량 장기투여 효과)

  • Kim, Young-Whan;Oh, Yeon-Mok;Jung, Man-Pyo;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.390-394
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    • 1993
  • Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.

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Clinical Observations in Vancomycin-Resistant Enterococci Isolated from Pediatric Patients (소아 환아에서 분리된 Vancomycin 내성 장구균에 대한 임상적 고찰)

  • Lee, Dong Woo;Lee, Kyung Jae;Jang, Gwang Choen;Kim, Dong Soo;Lee, Kyung Won;Park, Eun Suk
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.199-205
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    • 2001
  • Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

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