Vulvovaginal candidiasis (VVC) is a serious clinical and social issue. The questionnaire-based study was performed to assess the management of VVC in Lviv, Ukraine. Totally 408 women were enrolled in the survey. The lifetime prevalence of VVC was high (72.6 %). 35.8 % of women had VVC during the last year with the predominance of 1 episode (72.6 %). The most common symptoms were vaginal itching and cottage cheese-like vaginal discharge, affecting 89.7 % and 71.7 % of women with VVC, respectively. Stress (57.2 %) was the main self-reported factor associated with the VVC, followed by antibiotic therapy (49.7 %). Only 51.0 % of women with VVC sought a doctor’s help, 35.2 % of women reported about self-treatment. The management of VVC included usage of medicines and nonmedicinal interventions. Oral antifungals and vaginal medicines prevailed (86.2 % and 80.7 % of woman with VVC used them, respectively). The management of VVC was associated with inappropriate interventions, such as the treatment of an asymptomatic sexual partner (22.8 %), vaginal douching (11.0 %), taking oral antifungals with only local effectiveness for gastrointestinal fungal infections (natamycin and nystatin, 15.2 % vs 14.8 % respectively), using of vaginal drugs with none antifungal activity (5.1 %), and incorrect duration of the treatment (29.1 %). Rural residence (p = 0.000) and the absence of higher education (p = 0.001) significantly contribute to the inappropriate management of VVC. The management of VVC is often associated with self-treatment and different inappropriate interventions. Educational programs are required to improve the management of VVC. Pharmacists may significantly contribute to raising patients’ awareness and improving the management of VVC, especially in rural areas.
The objective of this study was to assess the consumption of antibiotics in children using the «AWaRe» classification of antibiotics (WHO, 2017) and metrics such as days of therapy (DoT) and length of therapy (LoT) per 1000 patientdays (PD). Antibiotics were administrated to 91.1% of inpatients in 2019 and 68.2% in 2021 (p<0.05). The main reason for antibiotic prescription was acute bronchitis in both study periods. Total DoT/1000 PD increased from 717.0 in 2019 to 760.0 in 2021 (p<0.05), and total LoT/1000 PD from 679.0 to 717.4 (p<0.05). Administration of antibiotics from the Access group decreased from 2.1% in 2019 to 1.8% in 2021 (p>0.05), antibiotics from the Watch group increased from 90.7% to 97.3% (p>0.05). Although a statistically significant reduction in the antimicrobial prescription rate, we found a considerable increase in (1) prescription antibiotics with a high risk of antimicrobial resistance, and (2) the main units of antimicrobial consumption.
UDC 615.03:615.276
The aim. To assess pharmacotherapy of hospitalised patients with coronary heart disease in Ukraine, identify the types of drug-related problems, and recommend interventions to improve the management of cardiac inpatients.
Materials and methods. The objects of the study were 25 medical records of inpatients with coronary heart disease complicated by heart failure and atherosclerotic cardiosclerosis. Methods applied: systematisation, generalisation, comparison, clinical and pharmaceutical approach. The statistical analyses were performed using the SPSS Trial.
Results. A comprehensive retrospective study was conducted to assess the management of cardiovascular diseases. In total, 25 patients were prescribed 62 drugs. It was established that 53.5 % of medicines were "Agents affecting the cardiovascular system"; out of them, 26.9 % were "other cardiac drugs" (C01E) used for enhancing cardiac energy metabolism. The study identified 597 drug-related problems (DRPs) (23.9±12.6 DRPs per patient) with the drug-drug interactions prevalence (62.6 %). Other common groups of DRPs were: (1) no indications for drug administration (8.5 %), and (2) despite indications, the drug was not prescribed (8.2 %). 99 DRPs (16.6 %; 95 % CI:13.7-19.8 %) were associated with "other cardiac drugs". They included 4 types of DRPs: (1) no indications for drug administration (33.3 %); (2) insufficient duration of the treatment (31.3 %); (3) drug-drug interactions (22.3 %); and (4) insufficient dosage or frequency of use (13.1 %).
Conclusion. Our findings suggest that the treatment of cardiac inpatients is associated with numerous DRPs. Thus, we formed a list of recommendations to improve the management of cardiovascular diseases in hospitalised patients
Резюме: У навчальному посібнику висвітлено актуальні питання менеджменту побічної дії ліків у системі вітчизняного та міжнародного фармакологічного нагляду, принципи моніторингу безпеки лікарських засобів на етапах до- і післяреєстраційних досліджень. Особлива увага присвячена менеджменту сигналів, ризиків і медикаментозних помилок, а також оцінці співвідношення користь/ризик в царині застосування ліків. Подано новітню інформацію стосовно менеджменту комунікації та інформування у фармаконагляді з акцентом на проблеми громадського здоров’я, сучасні засоби комунікації та джерела інформації. Насичення розділів посібника відповідає навчальній програмі Львівського національного медичного університету імені Данила Галицького з побічної дії ліків. Посібник призначений для лікарів усіх спеціальностей, фармацевтів, клінічних фармацевтів, викладачів, студентів вищих медичних (фармацевтичного) закладів, слухачів системи медичної та фармацевтичної післядипломної освіти.
Summary: The training manual covers topical issues of side effect management of drugs in the system of Ukrainian and international pharmacovigilance, principles of drug safety monitoring at the stages of pre- and post-registration studies. Special attention is devoted to the management of signals, risks, and medication errors, as well as to the assessment of the benefit/risk ratio in the field of medication use. The latest information on communication and information management in pharmacovigilance with an emphasis on public health issues, modern tools of communication, and information sources is presented. The content of the sections of the manual corresponds to the curriculum of the DanyloHalytskyLviv National Medical University on drugs side effects.
The manual is intended for doctors of all specialties, pharmacists, clinical pharmacists, teachers, students of higher medical (pharmaceutical) institutions, and students of the system of medical and pharmaceutical postgraduate education.