[Adequate antimicrobial drug use in a third level pediatric hospital]

Rev Med Inst Mex Seguro Soc. 2015 Mar-Apr;53(2):150-7.
[Article in Spanish]

Abstract

Background: The inadequate use of antimicrobials contributes to the development of bacterial resistance, reduces the effectiveness of established treatments and increases costs and mortality due to infectious diseases. The aim of this article was to evaluate if the use of antimicrobials was carried out properly in hospitalized pediatric patients.

Methods: An epidemiological observational, cross-sectional study was carried out in UMAE-48 in León, Guanajuato. Sample was non-probabilistic by convenience with 60 % of expected adequate treatments, 4 standard deviation. Analysis of statistical distribution frequency technique was used by type of final grade of each treatment that was administered: adequate, justified, therapeutic, restricted and prophylactic. The test chi-square test for comparing of percentages.

Results: Antimicrobial therapy were evaluated 283 prescriptions in 217 patients, 53 % were men and 47 % women. The general treatment was adequate in 51.2 %, justified 66 %, therapeutic 53.4 %, 40.8 % restricted and 48% prophylactic. Comparison of percentages with statistical test of chi-square test, we found association with adequate treatment in neonates service (chi-square test 8.287; p 0.004) and inadequate treatment in preterm infants service (chi-square test 4.853; p 0.028) p < 0, 05. The most commonly used antimicrobials, 43.7 % penicillins and 37.1 % aminoglycoside.

Conclusion: Only half of the treatments was antimicrobials are prescribed properly.

Introducción: el uso inadecuado de antimicrobianos contribuye al desarrollo de la resistencia bacteriana, reduce la efectividad de los tratamientos establecidos e incrementa los gastos y la mortalidad por enfermedades infecciosas. El objetivo de este artículo es evaluar si el uso de antimicrobianos en pacientes pediátricos hospitalizados se realiza de forma adecuada. Métodos: estudio epidemiológico observacional, transversal en la UMAE No. 48 de León, Guanajuato. Muestra no probabilística, con un 60 % de tratamientos adecuados esperados, desviación estándar 4. Se utilizó la técnica estadística de análisis de distribución de frecuencias por calificación final de tratamiento administrado: profiláctico, terapéutico, restringido, justificado y adecuado. Se realiza chi cuadrada para comparación de porcentajes. Resultados: se evalúan 283 prescripciones antimicrobianas en 217 pacientes, hombres (53 %) y mujeres (47 %). De los cuales fueron tratamientos adecuados: general 51.2 %, justificado 66 %, terapéutico 53.4 %, restringido 40.8 % y profiláctico 48 %. Comparación de porcentajes con chi cuadrada, asociación estadística significativa de tratamiento adecuado en neonatos (chi cuadrada 8.287; p 0.004) y tratamiento inadecuado en prematuros (chi cuadrada 4.853; p 0.028) con p < 0.05. Los antibióticos más usados fueron: penicilinas 43.7 % y aminoglucósidos 37.1 %. Conclusión: solo la mitad de los tratamientos antimicrobianos se prescriben de forma adecuada.

Keywords: Adequate use; Antimicrobial; Pediatrics.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Hospitals, Pediatric / standards*
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Male
  • Mexico
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Tertiary Care Centers / standards*
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Anti-Bacterial Agents