Vigilancia del uso de antibióticos en el Hospital Pediátrico del Centro Hospitalario Pereira Rossell: Susceptibilidad antimicrobiana; gasto y consumo de antibióticos

Gustavo Giachetto; Adriana Martínez; María Catalina Pírez; Gabriela Algorta; Patricia Banchero; Gabriela Camacho; Luciana Nanni; Ana María Ferrari

Authors

Gustavo Giachetto Universidad de la República, Facultad de Medicina, Clínica Pediátrica, Prof. Adjunto. Farmacología y Terapéutica, Prof. Adjunto
Adriana Martínez Universidad de la República, Facultad de Medicina, Clínica Pediátrica, Asistente
María Catalina Pírez Universidad de la República, Facultad de Medicina, Clínica Pediátrica, Prof. Agregada
Gabriela Algorta Universidad de la República, Facultad de Medicina, Bacteriología y Virología, Prof. Agregada. Centro Hospitalario Pereira Rossell, Laboratorio de Microbiología, Jefa
Patricia Banchero Universidad de la República, Facultad de Medicina, Farmacología y Terapéutica, Prof. Adjunta
Gabriela Camacho Centro Hospitalario Pereira Rossell, Departamento de Farmacia, Química Farmacéutica
Luciana Nanni Centro Hospitalario Pereira Rossell, Departamento de Farmacia, Jefa. Dra. Química Farmacéutica
Ana María Ferrari Universidad de la República, Facultad de Medicina, Clínica Pediátrica "A", Prof. Directora

Keywords:

ANTIBIOTICS, MICROBIAL DRUG RESISTANCE

Abstract

Background. Guidelines for empirical antibiotic treatment are a primary strategy to prevent the sustainable increased in bacterial resistance and costs. Since 1998, when a guideline for empirical antibiotic treatment for the most frequent infections in general ward and emergency units was adapted in the Hospital Pediátrico del Centro Hospitalario Pereira Rossell- HP-CHPR), this study began.
Objective. To analyze antibiotic overuse and costs, and antimicrobial susceptibility.
Method. Recommended antibiotics (by Hospital Guidelines: penicillin, aminopenicillin, cefalosporine, macrolides) costs were calculated for both general wards and emergency units. Consumption per in-hospital-patient was calculated on basis of defined daily dose (DDD)/100 day-beds for each antibiotic. Cost/consumption antibiotic for the period 2001-2002 were compared, antimicrobial susceptibility of the most frequent germens during 2001-2002 was compared to adapted therapeutic guidelines.
Results. Recommended antibiotic cost was in 2001 57% of antibiotic cost (2.206.652.57 pesos), in 2002 54% (1.441.280 pesos). Aminopenicillin was the antibiotic most frequently used. Intravenous cefuroxime consumption decreased 60% (from 13.1 to 5.36 DDD/100 day-beds). Intravenous ceftriaxone and oral amoxicillin increased 38% and 16% respectively. Consumption of other antibiotics remained constant. Antimicrobial susceptibility rates of most frequent germens (S. pseumoniae, S. aureus, E. coli, Shigella spp) to recommended antibiotics remained over 80%.
Conclusions. These are the first results of vigilance antibiotic use in HP-CHPR; they show the actuality and acceptance of the empirical antibiotic therapy guidelines proposed. Decrease in antibiotic cost is complex since cost variance during the same period.

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