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

[Jude Ike Nwokike <monkiyke@yahoo.com>]

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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