Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

Abstract

Objective. The aim of the study was to analyze the adequacy of the special category antibiotics prescriptions in the Emergency Department (ED) of a third level urban Hospital. Material and methods. A random sample of 100 different patients who were started with a special category antibiotic along 2018 in the ED was selected. The research team reviewed the medical history of the emergency and admission episode. The independent factors associated with the degree of adequacy of the treatment were determined by logistic regression. Results. A total of 97 prescriptions were analyzed of which 66 (68%) met the criteria of adequate prescription, 23 (24%) adequate prescription, but with equally recommended alternatives and 8 (8%) were inappropriate prescriptions. The degree of adequacy was 70% if the infection was related to healthcare and 75% if the patient had risk factors for multiresistant (MR) microorganisms' infection. The percentage of adequacy was higher in the cases in which the focus of the infection (72%) and the severity of the episode (73%) were specified. The independent variables that were associated with an adequate prescription were: the presence of risk factors for MR microorganisms' infection (OR: 2.35 95% CI: 1.65-3.17 p: 0.01), if the focus of the infection (OR: 3.79 95% CI: 1.72-4.22 p: 0.02) and the severity of the episode (OR: 3.09 95% CI: 1.12-3.09 p: 0.03) were specified. Conclusions. The prescription of special category antibiotics in ED is appropriate if the clinical guidelines are followed and if the setting of infection acquisition, the risk factors of MR microorganisms, the focus and the severity of infection are taken into account in clinical picture.

Use of antibiotics in patients who were attacked by animals that can transmit rabies

“…There is also evidence that an increase in the number of medications increases the probability of receiving a prescription for an antibiotic (Amaha et al, 2019). Finally, attacks classified as severe exposure were associated with a lower risk of inappropriate antibiotic use, a result that has also been shown in other clinical contexts (Muller et al, 2016; Osorio et al, 2020; Stuart et al, 2020). Muller et al (2016) and Osorio et al (2020) found that antibiotic prescriptions were adequate, especially when used for severe infections.…”

Vigilancia del consumo de antimicrobianos en 10 instituciones de salud entre 2013 y 2020 en Colombia

“…Con los hallazgos de este estudio se pueden llevar a cabo intervenciones particulares para cada institución; para ello, es importante identificar los factores que se asocian a una prescripción adecuada 20 , que incluyan medidas tales como la identificación de pacientes que más se beneficiarían con el tratamiento 21 , la realización de capacitaciones 22 , definición de antimicrobianos a restringir 5,22 , implementación de guías de diagnóstico 22 y de prescripción 23 , su seguimiento 22,23 y adherencia 24 , seguimiento farmacoterapéutico 22,23 y seguimiento a la resistencia 25 ,entre otras. De acuerdo a esto, se espera un efecto favorable, teniendo en cuenta que los programas de administración de antimicrobianos pueden ser bien aceptados por los médicos 26 .…”