Browsing by Autor "Juan Carlos Tapia Torrez"

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Ambulatory Antibiotic Use Patterns in Bolivia: Identifying Targets for Future Antibiotic Stewardship Efforts in Latin America
(Cambridge University Press, 2023) Rodolfo Quirós; Maria E. Mesalles; Elvio D. Escobar; Juan Carlos Tapia Torrez; Sara E. Cosgrove; Valeria Fabre
We evaluated antibiotic use in a private health insurance network in Bolivia with two different healthcare plans. The Health Maintenance Organization plan had 29% lower antibiotic consumption and fewer broad-spectrum antibiotics prescribed than the Preferred Provider Organization. Furthermore, we identified potential targets for future antibiotic stewardship efforts.
Antimicrobial stewardship in Latin America: Past, present, and future
(Cambridge University Press, 2022) Valeria Fabre; Sara E. Cosgrove; Clara Secaira; Juan Carlos Tapia Torrez; Fernanda C. Lessa; Twisha S Patel; Rodolfo Quirós
Implementation of antimicrobial stewardship programs (ASPs) in well-resourced countries has been associated with reductions in antibiotic-resistant infections and improved patient outcomes. Several guidance documents providing recommendations on how to structure antimicrobial stewardship activities at the national and hospital level in resource-limited settings have been published. However, few hospitals in Latin America report having a structure or resources needed for a successful ASP. Given the alarming increases in antimicrobial resistance in Latin America, better understanding of barriers to promote implementation of effective ASPs is urgently needed. We have summarized past and present antimicrobial stewardship activities in Latin American hospitals, and we describe key elements needed in future efforts to strengthen antimicrobial stewardship in the region.
Inappropriate dispensation of antimicrobials in pharmacies in Santa Cruz de la Sierra, Bolivia
(Elsevier BV, 2018) Juan Carlos Tapia Torrez; M.D. L.A. Camacho Berdeja; F. Calle Vela; D. Medinacelli Rea; Z. Peñanco Ponce; R. Rodriguez Paez; L. Rosel Carrasco; Elsa Gonzales; P. Vargas Parrado; Alberta Rizzo
Background: Although, since 1996, all medications must have been prescribed by a health professional (doctors or dentists) and their dispensation supervised by a pharmacist (Law 1737), recently in February 2017, the State Agency for Medicines and Health Technology (AGEMED) delivered the statement 00781, “CONTAINMENT OF ANTIMICROBIAL RESISTANCE”, establishing the obligation to comply with and apply Law 1737. However, the compliance to this provision has been irregular. The aim of this study was to determine the frequency of inappropriate dispensation of antimicrobials in pharmacies in Santa Cruz de la Sierra, Bolivia when clinical simulated situations where used (hidden client) Methods & Materials: A point-prevalence survey, was carried out between April and June 2017, in pharmacies in Santa Cruz de la Sierra, Bolivia. Through a simulation technique the antimicrobial dispensation was evaluated against two clinical situations: a) upper acute respiratory infection (URI); b) acute diarrhea (AD). Students of the last year of Pharmacy career were trained as patients to simulate the situations described above. Spontaneous and induced antimicrobial dispensation was evaluated. In all cases, the simulation was carried out without medical prescription. The antimicrobial delivery rate was evaluated as a percentage of the total contacts. The antimicrobials were grouped by family and by clinical situation. Results: Ninety-two pharmacies (86%) out of a total of 107 establishments were evaluated. Eighty (86%) of the pharmacies were tested by URI simulation and the rest (14%) by AD clinical situation. Antimicrobials were dispensed in 56 (61%) of the total simulations (54% spontaneous and 46% induced). In the rest of contacts (39%) the antimicrobials were not dispensed, even after the induction. While in the URI, the antimicrobials dispensed were: aminopenicillins (51%); macrolides (38%); Fluoroquinolones (8%) and cotrimoxazole (2%), in AD, the antimicrobials were: cotrimoxazole (86%) and nifuroxazide (14%). Dosing errors were also detected. Of total antimicrobials, 82% were dispensed by pharmacy assistants and 18% by pharmacists. Conclusion: Although in our country there is a norm that requires the dispensation of antimicrobials exclusively on prescription, it was not fulfilled in most of cases, allowing patients to access these agents without any control, increasing the risk of adverse events, drug interactions and development of resistance.