Document 2605
 DOCN  M94A2605
 TI    Study of urethritis management in pharmacies in Sao Paulo, Brazil.
 DT    9412
 AU    de Lima VC; Brito GS; Fernandes ME; Fini GI; Ribeiro MA; Morais JC;
       Souza G; Santa Casa Medical School, SP-Brazil.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):266 (abstract no. PB0494). Unique
       Identifier : AIDSLINE ICA10/94369970
 AB    INTRODUCTION: In Brazil men rely on STDs self-treatment through
       antibiotics obtained at pharmacies (estimated at 50-70% of STDs
       occurrences among men by MOH AIDS/STD Division). OBJECTIVE: To determine
       the attitude of pharmacies clerks (P.C.) towards men with symptoms of
       urethritis. METHODOLOGY: This study was conducted in 93-94. The
       municipality of Sao Paulo is divided in districts. The geographic
       downtown district was delimited and a list of 400 pharmacies was
       developed. Out of 400 pharmacies 53 (13%) were randomly chosen and
       visited by trained medical students (T.M.S.) that presented themselves
       to P.C. as having pain on urination and urethral discharge. Immediately
       after the visit at pharmacies the T.M.S. filled out a standard
       questionnaire. RESULTS: 68% T.M.S. were diagnosed by P.C. as having
       gonorrhea, 11% urethritis; 9% reported that they did not know the
       diagnosis and 11% mentioned other causes. From a total of 53 pharmacies
       74% of P.C. prescribed the treatment and only 19% recommended to T.M.S.
       to see a physician. When we analyze the prescription of antibiotics 33%
       prescribed correct drugs for the treatment of gonorrhea, but none
       prescribed drugs for the treatment of chlamydia. In 55% of the cases the
       drug of choice was correct, but the course of treatment was incorrect
       and in 12% of the pharmacies the drug of choice and the course of
       treatment were incorrect. The average cost of the treatment prescribed
       by P.C. was 21.81 USD (one third of the country minimum wage per month).
       Just one P.C. recommended the use of condoms and none reported that
       sexual partners needed a treatment. CONCLUSIONS: 1. 67% of the treatment
       prescribed was incorrect. 2. Chlamydia treatment was not considered by
       P.C. 3. Self-treatment may result in resistance to antibiotics. 4.
       Pharmacists and clerks need to be trained and be involved in STDs and
       AIDS prevention efforts.
 DE    Adult  Antibiotics/*THERAPEUTIC USE  Brazil  *Developing Countries
       Gonorrhea/*DRUG THERAPY  Human  Male  Pharmaceutical Services  Self
       Medication  Sexually Transmitted Diseases/*DRUG THERAPY  Treatment
       Outcome  Urethritis/*DRUG THERAPY  DUPLICATE PUBLICATION  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).