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Objectives This study aimed to assess physicians' adherence to the Infectious Diseases Society of America (IDSA) guidelines in managing and treating adult patients (≥ 18 years old) admitted with suspected cases of meningitis and to investigate any associations between guideline adherence and hospital length of stay (LOS) as well as all-cause mortality among these patients. Methods This retrospective observational study was conducted at a tertiary care hospital in Jordan, focussing on adult patients admitted with suspected meningitis between 1 January 2019 and 30 September 2022. The study aimed to assess the appropriateness of antibiotic prescriptions before culture results according to IDSA guidelines and calculate the overall adherence rate. Additionally, the study observed hospital LOS and all-cause mortality among the enrolled patients. Key findings Of the enrolled adult patients (n  = 118), 14.4% (n  = 17) were diagnosed with bacterial meningitis. Notably, only five patients (4.2%) were treated appropriately, adhering entirely to the IDSA guidelines, whereas the remaining 95.8% (n  = 113) showed various forms of non-adherence to these recommendations. The highest adherence to IDSA recommendations was observed in performing cerebrospinal fluid culture (100%), whereas the lowest adherence was noted in selecting appropriate doses and durations for the empiric antibiotics (n  = 18, 26.5% and n  = 21, 30.9%, respectively). No significant associations were found between adherence to IDSA treatment guidelines and hospital LOS (P  = .100) or all-cause mortality (P  = .332) among these patients. Conclusion This study revealed low overall adherence to IDSA guidelines among adult patients. Key areas for improvement in management include promptly selecting appropriate empiric antibiotics with correct dosing and duration to mitigate adverse effects and prevent bacterial resistance. [ABSTRACT FROM AUTHOR]

Objectives This study has evaluated the drug use pattern among adults attending the outpatient clinics of the Jordan University Hospital (JUH), by assessing the adherence of prescriptions to the World Health Organization (WHO) core prescribing indicators. Methods This is a cross-sectional study that was conducted during the period from October 2011 to January 2022 at JUH. Several prescriptions from 10 different adult outpatient clinics were reviewed to evaluate hospital adherence to the five WHO core prescribing indicators. Key findings To assess the WHO core prescribing indicators, data for 2451 prescriptions were reviewed. Around one-third of the patients (33.4%) were receiving polypharmacy (five medications or more). Results revealed that two core prescribing indicators were not following the standard values specified by the WHO; the average number of drugs prescribed per encounter (3.8 medications/prescription), and the percentage of drugs from the essential drug list (EDL) (54.1%). Endocrine clinics showed the highest average of drugs (6.3) per prescription and the highest percentage of prescriptions with injectable medicines (51.7%). On the other hand, ophthalmology clinics showed the highest percentage of prescriptions with antibiotics (29.9%) and the lowest percentage of drugs prescribed from the EDL at JUH (14.1%). Evaluating factors affecting the number of prescribed medications per encounter revealed that elderly patients (> 60 years), being female, referring to the endocrine clinic, and having insurance have a higher average number of medications per encounter compared with others (P < 0.05). Conclusion The proper prescribing practices in a sizable tertiary hospital in Amman, Jordan, are clarified by this study. The percentage of medications from EDL and the typical number of drugs/encounters did not comply with WHO requirements. The study findings should guide the Jordanian health policymakers in designing and implementing strategies to limit irrational prescribing practices and raise awareness of and ensure physician adherence to the national EDL. [ABSTRACT FROM AUTHOR]

Objectives The purpose of the study is to identify and analyse the barriers in surgical procedures where antibiotic dissipation is habitual. Methods Extensive literature search is carried out using different electronic databases (PubMed, Europe PMC, PLoS and Google Scholar) between January 2000 and December 2020. The articles were selected purely based on the inclusion criteria. Only qualitative and cross-sectional studies were selected to reduce the risk of bias. The JBI and AXIS checklists were used to assessed the quality of the enrolled articles. Data extractions were done by using a predesigned standardized data collection form. Key findings A total of 2067 articles were electronically retrieved but only 14 articles met the eligibility criteria. About 15 902 healthcare professionals (HCPs) with an average response rate of 64.7% were pooled for evidence synthesis. The majority of respondents (50%) discussed different barriers in their practice site for surgical antibiotic prophylaxis (SAP) administration. Barriers were categorized into four themes: lack of guideline availability and knowledge, lack of adherence to guidelines, lack of guideline knowledge and adherence and physician perceptions or off-label practices. A total of 723 (56.3%) out of 1282 HCPs from nine different studies reported a lack of adherence to guidelines during the perioperative process. The majority of respondents in three studies, 318 (82%) out of 386 HCPs, reported that physicians’ perceptions play a crucial role in prescribing SAP during surgeries. Conclusion This study concluded that the barriers within the practice site play a decisive role in SAP optimization and therefore all HCPs are recommended to maintain local/standard guidelines and adhere to them while prescribing SAP. [ABSTRACT FROM AUTHOR]

Objective: To assess self‐reported financial strain and persistence in asking treatment‐ and medication‐related questions in relation to medication nonadherence. Method: Data were analysed from a cross‐sectional study of adults with diabetes, hypertension or both in central Texas in 2013. Measures of medication nonadherence in the past 12 months, financial strain and patients' persistence in asking treatment‐ and medication‐related questions were identified. Medication nonadherence resulting from cost, transportation or work was compared with medication nonadherence resulting from other reasons. Binary and multinomial regression models were fitted to identify factors associated with medication nonadherence among the respondents. Key findings: In the bivariate model, medication nonadherence from any cause was significantly associated with financial strain, not asking questions about treatments or medications, and all demographic characteristics. However, in the multinomial model, medication nonadherence resulting from cost, work or transportation was only associated with not asking medication‐related question about financial strain, lack of health insurance, age and gender. This was true for nonadherence resulting from other reasons except that ethnicity was significant while gender was not. Conclusions: While removing financial strain could aid medication adherence, clinicians should also encourage patients to be persistent in asking questions about their medications until they understand the purpose for taking them. Our findings have implications for empowering patients to be more proactive in enhancing their adherence to medications. [ABSTRACT FROM AUTHOR]