Uso ambulatorio de cefalosporinas en una población colombiana: estudio de prescripción-indicación

Gaviria‐Mendoza, Andrés; Parra-Muñoz, Daniel Alejandro; Sepúlveda-Londoño, Daniel; Gómez-Franco, Juan Sebastián; Salazar-Cuevas, María Camila; Martínez-García, María Paula; Mafla-Ríos, Yuli Vanessa; Machado‐Alba, Jorge Enrique

doi:10.4067/s0716-10182021000600737

Cited by 2 publications

(7 citation statements)

References 19 publications

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“…In this group of patients, four out of five patients received inappropriate antibiotics. This finding is consistent with other reports [ 11 , 17 , 20 ]. In Canada, Ibrahim et al found that 63.3% of patients did not receive the antimicrobials recommended by management guidelines [ 17 ], while, in the United States, Sutton et al found that among patients who required hospital management, 73.0% did not receive adequate antibiotic management [ 20 ].…”

Section: Discussionsupporting

confidence: 94%

“…In Colombia, several studies on antibiotics in the outpatient setting have found a high proportion of inappropriate prescriptions [ 11 , 21 , 22 , 23 ]. Cephalosporins have been used to treat conditions not indicated in 55.6% of cases [ 11 ], macrolides in 31.3% of cases [ 21 ], fluoroquinolones in 24.0% of cases [ 23 ], and tetracyclines in 23.5% of cases [ 22 ]. This problem has also been described in international studies [ 12 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Infections of the skin and soft tissues are one of the main causes of doctor visits worldwide, exceeded only by infections of the respiratory system and urinary tract [ 10 ]. It is a concern that there are not enough studies with real-world evidence on the management of these patients in Columbia [ 4 , 11 ] and no studies have been reported since the publication of clinical practice guidelines. Consequently, the present study aimed to determine the treatment outcomes of a group of patients with uncomplicated skin and soft tissue infections in Colombia.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Valladales-Restrepo,

Aristizábal-Carmona,

Giraldo-Correa

et al. 2023

Microorganisms

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Background: Skin and soft tissue infections are one of the main causes of consultations worldwide. The objective was to determine the treatment of a group of patients with uncomplicated skin and soft tissue infections in Colombia. Methods: Follow-up study of a cohort of patients with skin infections who were treated in the Colombian Health System. Sociodemographic, clinical and pharmacological variables were identified. Treatments were evaluated using clinical practice guidelines for skin infections. Results: A total of 400 patients were analyzed. They had a median age of 38.0 years and 52.3% were men. The most commonly used antibiotics were cephalexin (39.0%), dicloxacillin (28.0%) and clindamycin (18.0%). A total of 49.8% of the subjects received inappropriate antibiotics, especially those with purulent infections (82.0%). Being cared for in an outpatient clinic (OR: 2.09; 95% CI: 1.06–4.12), presenting pain (OR: 3.72; 95% CI: 1.41–9.78) and having a purulent infection (OR: 25.71; 95% CI: 14.52–45.52) were associated with a higher probability of receiving inappropriate antibiotics. Conclusions: Half of patients with uncomplicated skin and soft tissue infections were treated with antibiotics that were not recommended by clinical practice guidelines. This inappropriate use of antibiotics occurred in the vast majority of patients with purulent infections because the antimicrobials used had no effect on methicillin-resistant Staphylococcus aureus.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Valladales-Restrepo,

Aristizábal-Carmona,

Giraldo-Correa

et al. 2023

Microorganisms

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“…However, it is common in the literature to find resistance to first-and second-generation cephalosporins, aminopenicillins with beta-lactamase inhibitors, and oxacillin, among others. [14][15][16] In Colombia, the use of antibiotics for unapproved indications is common, [29][30][31] a condition that leads to adverse clinical (increased length of hospital stay, morbidity, mortality, and antimicrobial resistance) and economic (increased costs of care) effects. 32 Thus, it is important to highlight that, in this study, the inappropriate use of antibiotics prevailed in most patients.…”

Section: Discussionmentioning

confidence: 99%

“…In Colombia, the use of antibiotics for unapproved indications is common, 29–31 a condition that leads to adverse clinical (increased length of hospital stay, morbidity, mortality, and antimicrobial resistance) and economic (increased costs of care) effects. 32 Thus, it is important to highlight that, in this study, the inappropriate use of antibiotics prevailed in most patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and use of antibiotics in a group of patients with snake bites in Colombia

Valladales-Restrepo,

Rojas-Ramirez,

Santander-Pai

et al. 2023

Therapeutic Advances in Infection

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Introduction: Millions of snake bites occur worldwide each year. Clinical practice guidelines generally do not recommend the use of prophylactic antibiotics. Objective: To determine the sociodemographic, clinical, and pharmacological variables and the use of antibiotics in a group of patients with snake bites in Colombia. Methods: A retrospective cross-sectional study was carried out. Patients affiliated with a Colombian health insurer who presented with snake bites between 2015 and 2022 were included. The cases were identified from the National Public Health Surveillance System. Sociodemographic, clinical and pharmacological variables were identified. Descriptive and bivariate analyses were performed. Results: A total of 643 patients were analyzed, with a median age of 30.8 years, and 74.7% were men. The most frequently identified genus of snake was Bothrops (88.8%), and most incidents were classified as mild ophidian accidents (61.6%). A total of 59.7% of patients received snake antivenom. A total of 13.8% and 2.2% of the patients had cellulitis or abscesses, respectively. A total of 63.5% received antibiotics (50.6% for prophylaxis and 12.9% for treatment), especially cephalexin (25.9%), and most of the antibiotic management was considered inappropriate (91.7%). Conclusion: Most patients with snake bites received antibiotics, especially for prophylactic purposes, a clinical behavior that goes against current evidence. The use of antibiotics with an unsuitable spectrum for the microorganisms that are usually found in the wounds of these patients is frequent. The development of local clinical practice guidelines is required to help reduce the overprescription of antibiotics, as the excessive use of antimicrobials is the main determinant of antimicrobial resistance.

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Uso ambulatorio de cefalosporinas en una población colombiana: estudio de prescripción-indicación

Abstract: Conflictos de interés: no hubo. Financiamiento: este trabajo de investigación no recibió fuentes de financiación.

Cited by 2 publications

References 19 publications

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World

Clinical characteristics and use of antibiotics in a group of patients with snake bites in Colombia

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