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Colegio de Medicina Interna de México.

2016, Number 4

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Med Int Mex 2016; 32 (4)

Suitability of antibiotic prescription in pneumonia associated with mechanical ventilation

Jarquín-Martínez M, Olvera-Sumano V, Reyes-Velasco L, Enríquez-Zárate Z, Acosta-Castellanos M

Language: Spanish
References: 17
Page: 407-414
PDF size: 647.44 Kb.


ABSTRACT

Background: The ineffectiveness of therapy and loss of quality of life of patients with pneumonia associated with mechanical ventila tion may vary according to the working methods of the selection and prescription of antibiotic therapy.
Objetive: To determine the appropriateness of the antibiotic prescription administered to patients with pneumonia associated with mechanical ventilation in the hospitalization services of Regional Hospital of High Specialty of Oaxaca from January 2012 to December 2014.
Material and Method: A cross-sectional, observational and analytical study was conducted in 213 patients with pneumonia associated with mechanical ventilation of the Regional Hospital of High Specialty of Oaxaca, Mexico.
Results: Mortality occurred in 40% of the cases; the risk factors associated were: antibiotic monotherapy, unsuitability of antibiotic prescription in terms of calculated dose, duration of treatment and dilution medium; as well as the association of hepatorenal failure.
Conclusion: The correct prescription of antibiotic therapy of pneumonia associated with mechanical ventilation is one of the most important aspects to ensure survival of patients; therefore, it is necessary the optimization of the prescriptions in terms of dosage by weight, duration of treatment, dilution medium and calculated dose in patients with renal and/or hepatic failure.


REFERENCES

  1. Tikhomirov E. WHO Programme for the Control of Hospital Infections. Chemiotherapia,1987;3:148-151.

  2. Norma Oficial Mexicana NOM-045-SSA2-2005, Para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales.

  3. Lasheras US. Neumonía asociada a ventilación mecánica, trabajo fin de grado. Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, España, 2012.

  4. Jain M, Miller L, Belt D, King D, Berwick DM. Decline in CU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Qual Saf Health Care 2006;15:235-239.

  5. Craven DE, Hudcova J. Diagnosis of ventilator-associated respiratory infections: (VARI): microbiologic clues for traquobronchitis (VAT) and pneumonia (VAP). Clin Chest Med 2011;32:547-557.

  6. Al-Tawfiq J, Abed MS. Decreasing ventilator-associated pneumonia in adult intensive care units using the institute for healthcare improvement bundle. Am J Infect Control 2010;38:552-556.

  7. Cipolle R, et al. Pharmaceutical care Practice Minneapolis. McGrawHill, 1998.

  8. Modelo Nacional de Farmacia Hospitalaria. Secretaría de Salud. 1a ed. México, 2009;16.

  9. “Idoneidad” (s/f). En Significados.com Disponible en: http://www.significados.com/idoneidad/ [Consultado: 23 de septiembre de 2015].

  10. Jordá R, et al. Recomendaciones para el tratamiento de neumonía intrahospitalaria grave. Arch Bronconeumol 2004;40:518-533.

  11. Chastre J, Wolff M, Fagon JY, Chevret S, et al. Comparison of 8 versus 15 days of antibiotic therapy for ventilatorassociated pneumonia in adults: a randomized trial. JAMA 2003;290:2588-2598.

  12. Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000;118:146-155.

  13. Abbo A, Carmeli Y, Navon-Venezia S, Siegman-Igra Y, Schwaber MJ. Impact of multi-drug-resistant Acinetobacter baumannii on clinical outcomes. Eur J Clin Microbiol Infect Dis 2007;26:793-800.

  14. Blot S, Vandewoude K, Colardyn F. Nosocomial bacteremia involving Acinetobacter baumannii in critically ill patients: A matched cohort study. Intensive Care Med 2003;29:471- 475.

  15. Garnacho-Montero J, Ortiz-Leyba C, Fernández-Hinojosa E, Aldabo-Pallas T, et al. Acinetobacter baumannii ventilator- associated pneumonia: Epidemiological and clinical findings. Intensive Care Med 2005;31:649-655.

  16. Leibovici L, Paul M, Poznanski O, Drucker M, et al. Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia: a prospective, observational study. Antimicrobian Agents Chemother 1997;41:1127-1133.

  17. Díaz E, Lorente L. El enfermo crítico con infección grave. Neumonía asociada a ventilación mecánica. Elsevier Doyma, 2010;34:318-324.




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