Duarte BD, Fiterre LI, Calero RJL

Language: Spanish
References: 18
Page: 423-431
PDF size: 166.99 Kb.

ABSTRACT

Objective: to characterize the prescription of antimicrobials in patients with decompensated chronic obstructive pulmonary disease.
Methods: descriptive and cross-sectional study that covered 131 patients with chronic obstructive pulmonary disease, who were prescribed some kind of antimicrobials in the internal medicine wards of "Joaquin Albarran" clinical and surgical hospital located in Havana, Cuba in the period of May 2011 through April 2012. The main causes of exacerbation were identified, the antimicrobial prescription was described and the association of severe decompensation and length of stay at hospital was determined. The statistical SPSS software analyzed the results.
Results: sixty five percent of patients presented with infectious decompensation. Antimicrobial prescription was mostly empirical in 92 % of cases and inadequate in 49 %. It was proven that the association of decompensation severity and antimicrobial prescription was statistically significant.
Conclusions: antimicrobials were inadequately prescribed in five out of ten patients diagnosed with decompensated chronic obstructive pulmonary disease, mostly in those cases without proven positive diagnosis of respiratory infection. As the decompensation severity decreases, the incidence of inadequate prescription increases.

REFERENCES

1. Ruiz M. Guía clínica de enfermedad pulmonar obstructiva crónica (EPOC). Parte I: diagnóstico. Rev Hospital Clínico Chile. 2011(19):15-20.

2. Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Guía de práctica clínica de diagnóstico y tratamiento de la EPOC [Internet]. 2011 [citado 25 nov 2012]. Disponible en: http://www.separ.es

3. Muiño Miguez A. Unidad médica de corta estancia. Rev An Med Intern. 2012;19(5):25-9.

4. Salazar JA, Alvarez A, Perez J, Garcia L. Effectiveness and safety of an emergency department short-stay unit as an alternative to standard inpatient hospitalisation. Emerg Med J. 2011;23(11):833-7.

5. Asociación Latinoamericana de Tórax (ALAT). Recomendaciones para el diagnóstico y tratamiento de la Enfermedad Pulmonar Obstructiva Crónica (EPOC) [Internet]. 2011 [citado 28 nov 2012]. Disponible en: http://www.alat.es

6. Jasovich A. Control of Antimicrobial Agents: Control until it hurts? Rev Chilena Infectol. 2010;20(Supl 1):S63-S69.

7. Alcolea Batres S, Villamor León J, Álvarez-Sala R. EPOC y estado nutricional. Rev Arch Bronconeumol. 2012;43(5):283-8.

8. Llor C, Bjerrum L, Munck A. Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice. Estudio multicéntrico. Madrid: SAGE; 2012.

9. Moya Mir MS, Muñez Rubio E. Epidemiología de la exacerbación de la EPOC y de la infección respiratoria en urgencias. [Tesis Doctoral]. Clínica Puerta de Hierro. Departamento de Medicina de la Universidad Autónoma de Madrid; 2010.

10. Iyer Parameswaran G, Sethi S. Pseudomonas Infection in COPD. [Tesis Doctoral]. Departament of Medicine, University at Buffalo, New York; 2012.

11. Erkan L. Rol de las bacterias en las exacerbaciones de EPOC. [Tesis Doctoral]. Samsun, Turquía: MGM; 2012.

12. Fowler RA, Flavin KE, Barr J. Variability in Antibiotic Prescribing Patterns and outcomes in Patients With Clinically Suspected Ventilator-Associated Pneumonia. Chest. 2003;123(3):835-44.

13. Llanos-Zavalaga F. Características de la Prescripción de Antibióticos en los Consultorios de Medicina del Hospital Cayetano Heredia de Lima, Perú. Rev Nac Med. 2012;1(12):27-34.

14. Ramos Martínez I, Cornide Santos R, Marcos García E. Calidad de la prescripción de antibióticos en un servicio de urgencia hospitalario. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas. [Tesis Doctoral]. Hospital Universitario Puerta de Hierro, Madrid: SAGE; 2012.

15. Guanche G, Izquierdo-Cubas H, Zambrano F. Uso de Antimicrobianos en Instituciones de Salud de Cuba. Revista de medicina interna y crítica. MEDICRIT. 2009;6(1):24-30.

16. Fiterre Lancis I, Mir Narbona I, Enseñat Sánchez R. Calidad de prescripción de agentes antimicrobianos en pacientes hospitalizados en servicios clínicos. Rev Cubana Med. 2011;50(1):12-5.

17. Ozkurt Z, Serpil E, Kadanali A. Changes in Antibiotics Use, Cost and Consumption after an Antibiotic Restriction Policy Applied by Infectious Disease Specialists. [Tesis Doctoral]. Department of Infectious Diseases, Ataturk University Medical School, Turkey: ERZURUM; 2009.

18. Carrillo Rivas M, García-Castillo Riesgo L, Agüero Balbín R. Valoración del seguimiento de las guías clínicas en las exacerbaciones de la EPOC. [Tesis Doctoral]. Hospital Universitario Marqués de Valdecilla, Santander, España: SAGE; 2009.