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Anti-anxiety drug usage in the United States, 1989.

In 1989 more than 36.4 million new prescriptions for minor tranquilizers (MTs) were written in the continental United States. These drugs were 81 percent of all tranquilizers prescribed; the majority of the MTs were benzodiazepines, with hydroxyzines, meprobamates and buspirones making up the remaining 19 percent. The predominant diagnosis associated with the total MT group of drugs was "anxiety states". This condition was listed as a reason for one in every four new prescriptions for MTs. Per capita new prescriptions averaged 232.3 per 1,000 population, with the highest rate reported in the East South Central area and the lowest in the Pacific states. Psychiatrists accounted for 20 percent of the new prescriptions, just behind internists with 21 percent.

Anti-Anxiety Agents↗

Non-steroidal anti-inflammatory drug usage and requirement in elderly acute hospital admissions.

There is a strong feeling that despite the increasing awareness of their adverse effects, non-steroidal anti-inflammatory drugs (NSAIDs) are not always used appropriately. To examine this problem amongst elderly patients who may be at particular risk, 500 acute admissions to Health Care of the Elderly wards were studied prospectively. Sixty-five patients were currently receiving NSAIDs; 56 had medical conditions possibly caused by, or aggravated by NSAIDs. Indications for NSAIDs were often no longer apparent, and these drugs were successfully discontinued in 56; in 22 no alternative therapy was required. Importantly, following discharge the majority of patients remained off NSAIDs. These data support the need for continual review of NSAID requirements and regular monitoring for adverse effects, particularly in this high risk group.

Aged↗

Reliability of recall of drug usage and other health-related information.

Health-related information from multiple sources was collected on 334 women living in two predominantly white, affluent retirement communities near Los Angeles as part of a case-control study of a serious chronic disease (cancer of the breast) conducted in 1977-1978. There was no evidence on interview of cases preferentially recalling more drug use or past diseases than controls. Agreement between interview and medical record for all disease conditions studied as well as for height, weight, and most menstrual and reproductive variables was of the order of 90% or better. Age at last menstrual period as reported on inerview did not correspond particularly well with that recorded on the medical record. Agreement between data sources for ever/never drug use varied considerably with the type of drug studied, from a low of 69% for use of barbiturates and related drugs to a high of 87% for use of antihypertensive medications. Estrogen usage information was collected in detail. Better correspondence was observed between medical record and interview than between either medical and pharmacy records or interview and pharmacy records.

Aged↗

Vancomycin and teicoplanin use in Victorian hospitals. The Victorian Drug Usage Evaluation Group.

OBJECTIVE: To determine patterns of prescribing of glycopeptide antibiotics (vancomycin and teicoplanin) in Victorian hospitals and identify areas for targeted intervention. DESIGN: A concurrent, observational, multisite evaluation of drug use. SETTING: Thirty-five Victorian hospitals, 1-14 September 1997. STUDY POPULATION: Patients commencing a glycopeptide antibiotic course. MAIN OUTCOME MEASURES: Rate of glycopeptide antibiotic use; indications; duration of use; main hospitals using glycopeptide antibiotics. RESULTS: 293 patients (269 adults and 24 neonates) commenced on 302 glycopeptide antibiotic courses: 296 intravenous (i.v.) vancomycin courses and three each of oral vancomycin and parenteral teicoplanin. The overall rate of use was 10.3 courses per 1000 inpatient separations. Of 271 i.v. vancomycin courses for adults, 176 (65%) were for treatment--120 empirically. The median duration of treatment courses was 4.7 days (interquartile range, 2.0-8.2 days). A flucloxacillin-resistant organism was confirmed for 44% of treatment courses. Ninety-five i.v. vancomycin courses were for prophylaxis, including for cardiac (54%) and vascular surgery (21%); 82% of prophylactic courses were administered for less than 24 hours. Of all the glycopeptide antibiotic courses, 69% were administered at five major metropolitan hospitals. CONCLUSIONS: Glycopeptide antibiotic use in Victoria is concentrated in the major metropolitan hospitals. Prolonged durations of vancomycin therapy, including for surgical prophylaxis and empirical therapy not subsequently confirmed by microbiology findings, would be suitable targets for interventional strategies.

Administration, Oral↗