Gómez TPJC

Language: Spanish
References: 11
Page: 97-103
PDF size: 82.63 Kb.

ABSTRACT

Objective: To evaluate the use of antibiotics in patients interned at the Central Hospital of the Peruvian Air Force. Materials and methods: It was studied every hospitalized patient, from August 2001 to January 2002, at the pediatrics, surgery, gynecology and medicine services, receiving an antibiotic treatment since they entered the hospital, excluding newly-born babies, patients from critical units and psychiatric ones, besides those patients who had been prescribed an antibiotic treatment previous to the hospitalization. The studied variables were: a. Prescriptions given in order to pursue therapeutic and prophylactic aims. b. Percentage of prescriptions performed on a microbiological basis. c. Average antibiotic used per patient, association frequency and frequency of the number of days per prescribed antibiotic. d. Percentage of patients who receive surgical prophylaxis before surgery, and percentage of these ones who receive it 2 hours before surgery. e. Percentage of patients that receive, in a prophylactic way, postoperative antibiotic treatment and the frequency of days with postoperative antibiotics. It was only included those patients who were taken complete data from clinical record and the data after certificate of discharge. Results: A total of 219 patients were included in this study. They were given 367 antibiotic therapies, 246 for therapeutic purposes, 106 for surgical prophylaxis, and 27 for medical prophylaxis. The average antibiotic per patient was of 2.15 when the treatment was employed for therapeutic purposes. 31% of the antibiotic use for therapeutic purposes was given as a monotherapy, 68% received more than one antibiotic; from them, 50% had two or more antibiotics at the same time, and the other half got two or more in a separated way. The percentage of treatment for therapeutic purposes and based upon a microbiological aim was of 13% (15 out of 114 patients). From the 106 patients receiving antibiotics for surgical prophylaxis, 51% was given them before surgery; from them, 48% had the antibiotics two hours previous to surgery. The number of days with antibiotic treatment after surgery presented an average of 3.4 days. Conclusions: The use of antibiotics was prescribed for therapeutic purposes and for surgical prophylaxis. With a therapeutic object, two or more antibiotics were employed, without a microbiological support. In surgical prophylaxis: just in a few cases it was kept the two-hours previous to surgery. Antibiotics were used in postoperative, in spite of the fact of having performed antibiotic prophylaxis.

REFERENCES

1. Wyatt TD. Antibiotic prescribing: the need for a policy in general practice. British Medical Journal 1990; 300(6722): 441-444.

2. Straand J. Prescribing systemic antibiotics in general practice. A report from the more and Romsdal prescription study. Scand Journal of Primary Health Care 1998; 16(2): 121-127.

3. Carrie AG. Antibacterial use in community practice: assesing quantity, indications and appropriateness, and relationship to the development of antibacterial resistance. Drugs 1999; 57(6): 871-881.

4. Austin DJ. The relationship between the volume of antimicrobial consumptionin human communities and the frequency of resistance. Proc Nalt Acan Sci USA 96: 1152-1156.

5. Magee J. Antibiotic prescribing and antibiotic resistance in community practice: retrospective study, 1996-8. British Medical Journal 1999; 319: 1239-1240.

6. Orrett FA. Urinary tract infection in general practice in a rural community in South Trinidad: Saudi Medical Journal 2001; 22(6): 537-540.

7. Kraft CA. Trimethropim resistance in urinary coliforms from patients in the community: plasmids and R-transfer. Journal of Antimicrobial Chemotherapy 1985; 15(3): 311-318.

8. Philip JW. Encouraging good antimicrobial prescribing practice: A review of antibiotic prescribing policies used in the South East Region of England. http:/www.biomedcentral.com/1471-2458/1/4.

9. Majeed A. Age and sex-specific antibiotic prescribing patterns in general practice in England and Wales in 1996. British Journal of General Practice 1999; 49(446): 735-736.

10. El uso de antibióticos en producción animal y la resistencia antimicrobiana. XI Reunión Interamericana de Salud Animal a nivel Ministerial: OPS/OMS Washington D.C. 13-15 de Abril de 1999.

11. London N. Effect of antibiotic therapy on the antibiotic resistance of faecal Escherichia coli in patients attending general practitioners. Journal of Antimicrobial Chemotherapy 1994; 34(2): 239-246.