The cost of excessive postoperative use of antimicrobials: the context of a public hospital

Abstract

ABSTRACT ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To evaluate the improper use of antimicrobials during the postoperative period and its economic impact. Methods Methods Methods Methods Methods: We conducted a prospective cohort study by collecting data from medical records of 237 patients operated on between 01/ 11/08 and 31/12/08. Results Results ResultsResults Results: from the 237 patients with the information collected, 217 (91.56%) received antimicrobials. During the postoperative period, 125 (57.7%) patients received more than two antimicrobials. On average, 1.7 ± 0.6 antimicrobials were prescribed to patients, the most commonly prescribed antibiotic being cephalothin, in 41.5% (154) of cases. The direct cost of antimicrobial therapy accounted for 63.78% of all drug therapy, this large percentage being attributed in part to the extended antimicrobial prophylaxis. In the case of clean operations, where there was a mean duration of 5.2 days of antibiotics, antimicrobials represented 44.3% of the total therapy cost. ConclusionConclusion Conclusion Conclusion Conclusion: The data illustrate the impact of overuse of antimicrobials, with questionable indications, creating situations that compromise patient safety and increasing costs in the assessed hospital.

Adherence to guidelines for surgical antibiotic prophylaxis: a review

“…The adherence of the studies with this outcome was not considered satisfactory and is not consistent with authors that claim that a more prolonged administration of prophylactic antibiotics did not favor the prevention of surgical wound infection, and may encourage the development of microbial resistance, in addition to being costly to patients, increasing the direct costs of care. 31 , 32 …”

Compliance Rate of Surgical Antimicrobial Prophylaxis and its Association with Knowledge of Guidelines Among Surgical Residents in a Tertiary Care Public Hospital of a Developing Country

“…Due to proper antimicrobial prophylaxis, the incidence of SSIs has been reduced by 50% in some procedures and proper SAP is now considered the most important preventive measure against SSIs [7]. However, the literature suggests inappropriate SAP practice regarding the prescription, timing, and duration of antibiotic use worldwide, which prolongs the hospital stay of patients, increases patient morbidity (by exposing them to the adverse effects of antibiotics), promotes bacterial resistance, and puts an economic burden on health care [5,8-9]. Thus, it is the need of the hour to practice a rational SAP and minimize the side effects mentioned above.…”

Segurança do paciente no uso de antibiótico hospitalar: uma revisão da literatura

“…This action is necessary so that the effect between the peak of the medication and the minimum level required for bacterial death is effective. 17 Article VI examined the incidence of redundant antibiotic combinations in US hospitals and identified the existence of high treatment costs associated with combinations in these avoidable patterns. It also found that these combinations contribute to bacterial resistance.…”