[Assessment of antibiotic use and impact of an intervention intended to modify the prescribing behavior in surgical prophylaxis in 6hospitals in the metropolitan area of Monterrey, Mexico].

Autor:	Palacios-Saucedo GDC; Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México. Electronic address: palsaugc@gmail.com., de la Garza-Camargo M; Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México., Briones-Lara E; Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia N.° 23, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México., Carmona-González S; Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México., García-Cabello R; Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México., Islas-Esparza LA; Hospital General de Zona N.° 33, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México., Saldaña-Flores G; Hospital Christus-Muguerza de Alta Especialidad, Monterrey, Nuevo León, México., González-Cano JR; Hospital Christus-Muguerza de Alta Especialidad, Monterrey, Nuevo León, México., González-Ruvalcaba R; Hospital San José, Tecnológico de Monterrey, Monterrey, Nuevo León, México., Valadez-Botello FJ; Hospital Metropolitano, Secretaría de Salud, Monterrey, Nuevo León, México., Muñoz-Maldonado GE; Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México., Montero-Cantú CA; Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México., Díaz-Ramos RD; Coordinación de Unidad Médica de Alta Especialidad, Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Ciudad de México, México., Solórzano-Santos F; Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Jazyk:	Spanish; Castilian
Zdroj:	Cirugia y cirujanos [Cir Cir] 2017 Nov - Dec; Vol. 85 (6), pp. 459-470. Date of Electronic Publication: 2017 Jan 04.
DOI:	10.1016/j.circir.2016.10.033
Abstrakt:	Background: Improper use of antibiotics increases antimicrobial resistance. Objective: Evaluate the use of antibiotics and the impact of an intervention designed to improve antibiotic prescription for surgical prophylaxis in 6 hospitals of Monterrey, Mexico. Material and Methods: Design: A prospective multicenter survey and a pretest-postest experimental study. Phase 1: Survey to evaluate the use of antibiotics through an especially designed guide. Phase 2: Intervention designed to improve antibiotic prescription for surgical prophylaxis by the medical staff by using printed, audiovisual and electronic messages. Phase 3: Survey to evaluate the impact of the intervention. Analysis: Frequencies, percentages, medians, ranges and X 2 test. Results: Phase 1: We evaluated 358 surgical patients, 274 prophylactic antibiotic regimens. A total of 96% of antibiotics regimens began with inappropriate timing (290/302), 82.8% were inappropriate regimens (274/331), 77.7% were in inappropriate dosage (230/296), 86% of inadequate length (241/280), and in 17.4% restricted antibiotics were used (52/299). Phase 2: 9 sessions including 189 physicians (14 department chairs, 58 general practitioners and 117 residents). Phase 3: We evaluated 303 surgical patients, 218 prophylactic antibiotics regimens. Inappropriate treatment commencement was reduced to 84.1% (180/214) (P<0.001), inappropriate regimens to 75.3% (162/215) (P=0.03), inappropriate dosages to 51.2% (110/215) (P<0.001), and use of restricted antibiotics to 8.3% (18/215) (P=0.003). Conclusions: Inappropriate use of prophylactic antibiotics in surgery is a frequent problem in Monterrey. The intervention improved the antibiotic prescription for surgical prophylaxis by reducing inappropriate treatment commencement, regimens, dosages, and overuse of restricted antibiotics. It is necessary to strengthen strategies to improve the prescription of antibiotics in surgical prophylaxis. (Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)
Databáze:	MEDLINE
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