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Biomedical subjects

M Madurga

Publications and source records attributed to M Madurga.

15 recordsLinked to original sources
PubMed2004

Increase of resistance to macrolides in invasive Streptococcus pneumoniae in Spain (2000-2001).

This study examined the antimicrobial resistance of 1,278 invasive Streptococcus pneumoniae isolates from 41 Spanish laboratories participating in the European Antimicrobial Resistance Surveillance System (EARSS) during 2000 and 2001. Twenty-nine laboratories participated during both years and provided 950 of the isolates. Each laboratory used its own susceptibility testing methods. External quality assessment was performed annually by each participating laboratory. Significant increases in penicillin and erythromycin resistance were observed between 2000 and 2001. This increase was particularly noticeable in isolates from the laboratories participating during both years and in isolates from children and elderly patients.

Adolescent↗
PubMed2000

[Ticlopidine use in Spain: a pharmacy-based drug utilization study].

BACKGROUND: In 1997 a program was set up to improve the use of ticlopidine. In the present study we assess whether this objective was achieved. PATIENTS AND METHODS: We carried out a pharmacy-based cross-sectional study. RESULTS: Out of 346 patients interviewed, 56% presented an off-label indication for ticlopidine. In 23% of patients the daily dose used was lower or higher than the recommended. Only 28% patients had the fortnightly blood monitoring performed at the time of interview. CONCLUSIONS: The use of ticlopidine in Spain is not consistent with the summary of product characteristics and the program set up to improve it did not achieve a satisfactory result.

Aged↗
PubMed1998

[Use of antihypertensive drugs in Spain, 1985-1995].

BACKGROUND: This study has analysed the trend of antihypertensive drugs consumption in Spain from 1985 to 1995, its economical impact and the correlation with the available scientific evidence. The utilization of calcium channel blockers in the context of the recent controversial about their safety profile was also evaluated. METHODS: Drugs from the ATC groups C02, C03 (excluding C03C), C07, C08 (excluding nimodipine and nicardipine) and C09 were included (ATC classification, 1996 version). Drug utilization data and cost figures were obtained from the databases ECOM and FAR-90 of the Ministry of Health. These databases contain the number of packages sold in community pharmacies that are charged to the National Health System. Data are expressed in defined daily doses per 1,000 inhabitants per day (DHD). The cost is expressed in current and constant pesetas. RESULTS: The use of antihypertensives increased from 34.78 DHD in 1985 to 103.55 DHD in 1995. Angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) are responsible for 89% of the total increase. Thiazides and beta-blockers showed a mild increase, although its relative contribution to the total figures declined from 72 to 32% at the end of the period. Rauwolfia alcaloids and antiadrenergic drugs sales were negligible (0.4% of total sales in 1995). Within the thiazides, consumption was concentrated in products containing > or = 50 mg hydrochlorothiazide or equivalent. Enalapril, captopril, nifedipine and the fixed-dose association of hydrochlorothiazide with amiloride were the most widely used drugs. The cost of antihypertensive drugs in current pesetas raised eight times through the study period reaching 105,501 millions pesetas in 1995; 89% of the cost corresponded to ACEI and CCB. Expressed in constant pesetas the cost increase was four fold. The recent controversia about CCB did not have influence on its consumption. CONCLUSIONS: The pattern of use of antihypertensive drugs in Spain does not follow the available scientific evidence. Drugs with less documented effectiveness are the most prescribed; even considering the same effectiveness, efficiency is lower for drugs with higher utilization rates. The available presentations for thiazides makes their utilization in the optimal dosification difficult.

Adrenergic Antagonists↗
PubMed1997

[Evolution of antidepressive drug consumption in Spain. The impact of selective serotonin re-uptake inhibitors].

BACKGROUND: The pattern of use of antidepressive drugs in Spain through 1985-1994 is studied. Special emphasis is given to the impact of selective serotonin re-uptake inhibitors introduction at the end of the eighties. MATERIAL AND METHODS: Information on drug utilization was obtained from the databases of the Ministry of Health which contain the number of packages sold in community pharmacies and charged to the National Health System. Data are expressed in defined daily doses (DDD) per 1,000 inhabitants per day. RESULTS: The use of antidepressants (excluding fixed-dose combinations) increased from 2.7 DDD/1,000 inhabitants/day in 1985 to 9.3 DDD/1,000 inhabitants/day in 1994 (247%). All the subgroups contributed. Selective serotonin re-uptake inhibitors utilization was 4.71 DDD/1,000 inhabitants/day in 1994, representing 71% of the overall increase during the study period. The consumption of fixed-dose combinations decreased in 17%. Since 1991 fluoxetine is the antidepressant most widely used. The consumption through pensioner prescriptions is proportionally higher for second generation antidepressants than for the other groups. CONCLUSIONS: Antidepressive drugs consumption in Spain increased three times in the last ten years, though it is still below the estimated point prevalence of depression. Selective serotonin re-uptake inhibitors introduction has modified the pattern of use of antidepressants but their impact on the use of the rest of the group has been apparently low.

Antidepressive Agents↗
PubMed1996

Laboratory diagnosis and molecular epidemiology of an outbreak of hepatitis C virus infection among recipients of human intravenous immunoglobulin in Spain.

BACKGROUND: Passive transfer of antibody to hepatitis C virus (HCV) has been thought to occur after infusion of human intravenous immunoglobulin (IVIG), as anti-HCV and/or HCV RNA was commonly found in that product. Recently, however, HCV RNA was detected in the serum of recipients of IVIG. Establishment of a causal relationship between IVIG therapy and HCV infection in recipients was attempted. STUDY DESIGN AND METHODS: Anti-HCV and HCV RNA sequences were investigated in serum samples from 39 persons who received a human IVIG product in seven different hospitals in Spain. HCV RNA was also investigated in two batches of the IVIG shared by some recipients. All the viral RNA detected were characterized with a line probe assay, restriction fragment length polymorphism analysis of the 5'-noncoding and core regions, and sequencing of the nonstructural 5 region. RESULTS: On the basis of both clinical and laboratory data, a relationship could be established between the IVIG therapy and the acquisition of the HCV infection by the recipients. Several HCV strains were detected among the recipients, with most of the recipients coming from the same hospital presenting with closely related strains. Moreover, an HCV strain almost identical to the main strain detected among the recipients was found in one batch of the IVIG that probably was shared by most of them. Follow-up studies and evaluation of low-avidity anti-HCV IgG suggested that both acute primary infections and reinfections were produced. In one case, direct evidence of reinfection by a different HCV strain was obtained. CONCLUSION: The results did not exclude the possibility that a second HCV strain associated with a further, unidentified batch of the IVIG could have contributed to this outbreak.

Adolescent↗
PubMed1996

Hypnotic drug use in Spain: a cross-sectional study based on a network of community pharmacies. Spanish Group for the Study of Hypnotic Drug Utilization.

OBJECTIVE: To investigate how hypnotic drugs are used in Spain, specifically, (1) to characterize the user population in some simple demographic (e.g., sex, age) and clinical (e.g., type of insomnia, type of physician who prescribed the drug) variables; (2) to estimate the proportion of long-term users (> 3 mo); (3) to determine the frequency of different administration schedules; (4) to determine whether the kind of hypnotic drug prescribed according to the duration of its effect correlates with the type of sleep disorder or patient age; and (5) to compare the dosage used by the elderly with that used by adults. DESIGN: Cross-sectional pharmacy-based study. SETTING: A network of 318 community pharmacies throughout Spain. SUBJECTS: Patients (n = 5324) requesting a hypnotic drug for insomnia who agreed to take part in the study. MAIN OUTCOME MEASURES: Distribution of the use of hypnotic drugs by age, sex, type of insomnia, type of physician, specific hypnotic drug, daily dosage, treatment schedule, and duration of treatment. RESULTS: Women (67%) and the elderly (58%) constituted the largest subgroups in the sample. Difficulties in sleep onset and in sleep maintenance as single disorders were reported by 38% and 37% of users, respectively. Prescriptions were written by general practitioners in 80% of cases. Daily use was reported by 88% and long-term use (> 3 mo) by 72% of the users. Long-term treatment was two- to threefold more frequent in the elderly than in middle-aged subjects. Intermediate-action hypnotic drugs were used by 59% of subjects, short-action drug by 24%, and long-action drugs by 17%. The type of hypnotic drug prescribed was not related to the kind of sleep disorder or the age of patients. Specialists prescribed long-action hypnotic drugs more often than did general practitioners. No relevant differences were observed between dosages used by the elderly and those used by adults. In both groups the dosage taken by most patients, regardless of the drug, corresponded to the available strength. Substitution drugs for triazolam belonged to the intermediate-action class in 53% of the cases. CONCLUSIONS: Recommendations on hypnotic drug use are largely not followed in Spain. Most patients are taking hypnotic drugs daily, over long time periods, and without an adequate dosage titration according to age. Measures should be taken to correct this situation.

Administration, Oral↗
PubMedDate not supplied

[Safety of meningococcal A and C vaccine. Data from the Spanish drug surveillance system. Meningococcal Vaccine Research Group of the Spanish System of Drug Surveillance].

OBJECTIVE: Data on meningococcal vaccines safety are scanty. In 1997 several vaccination campaign took place in Spain. Thus, this situation was used to improve our knowledge about the safety profile of this vaccine. METHODS: An inquiry was carried out to the Regional Centers of the Spanish Pharmacovigilance System to know the number of vaccinated people and the type and number of suspected cases of adverse reactions. RESULTS: There were 133 identified cases of suspected adverse reactions associated with meningococcal A and C vaccine until June 1st, 1998. Most of them affected the skin (25,3%) or nervous system (similar proportion). Those of allergic reactions accounted for 35,2%. Two cases were considered as severe, although they were resolved without secuelae. CONCLUSIONS: Serious risks were not detected. The Spanish Pharmacosurveillance System as an epidemiological surveillance resource has been useful to know the safety problems associated with antimeningococcal vaccine in the community.

Adolescent↗
PubMedDate not supplied

Trends in the supply and use of lipid-lowering drugs in Spain, 1983 through 1991.

Trends in the supply and use of lipid-lowering drugs in Spain were studied throughout the period of 1983-1991. Although the supply of such drugs remains excessive, a trend towards more rational standards has been apparent: 20 specialties out of 53 existing in 1983 have been withdrawn (10 fixed-dose combinations and 10 obsolete drugs). The overall use of lipid-lowering drugs rose from 2.51 DDD/1000 inhab/day in 1983 to 8.47 DDD/1000 inhab/day in 1991. The increase was mostly attributable to the subgroup of fibric acid derivatives (1.23 DDD/1000 inhab/day in 1983 and 6.14 in 1991). The bile acid sequestrants accounted for a small fraction of the overall use (0.23 DDD/inhab/day in 1991), in spite of its increasing consumption. The use of the two subgroups, nicotinic acid derivatives and fixed-dose combinations, has declined. The introduction into the market of HMG-CoA reductase inhibitors in 1991 contributed to the increase of the overall use in 1.28 DDD/1000 inhab/day but it seems not to have any negative influence on the use of other subgroups. Although the prevalence rates of hypercholesterolemia are similar, the use of lipid-lowering drugs in 1991 in Spain was 3 to 8 times higher than that of the Nordic countries. In conclusion, our data suggest that lipid-lowering drugs are highly used in Spain, at least in comparison with other western countries, and that the pattern of drug use is not in accordance with international recommendations.

Drug Utilization↗