Impacto sobre la resistencia bacteriana de la revisión previa de la prescripción de antibióticos por el servicio farmacéutico en hospitales del Atlántico (Colombia)
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Fecha
2020
Autores
Hernández-Gámez, Orison
Camacho-Romero, Oscar
González-Torres, Henry J.
Bolívar-González, Samir
Campo-Urbina, Mirna
Zuluaga-De León, Iván
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Universidad del Norte
Resumen
Objetivo: Determinar el impacto sobre la resistencia bacteriana de la revisión previa de la
prescripción de antibióticos por parte del servicio farmacéutico en hospitales de mediana y
alta complejidad del departamento del Atlántico (Colombia).
Metodología: Se analizaron los valores de resistencia de bacterias Gram positivas, Enterobacterias y Gram negativos no fermentadores reportados en cinco institutos prestadores
de salud (IPS) del departamento del Atlántico, en dos periodos (preintervención e intervención), de 12 meses cada uno, entre junio de 2015 y mayo de 2017.
Resultados: Durante los dos periodos de estudio se identificaron 68 microorganismos en
8590 aislamientos microbiológicos provenientes de muestras de orina (40,3 %), sangre
(21,7 %), tejidos (8,5 %) y otras (29,5 %). Los microorganismos aislados más frecuentemente fueron Escherichia coli (28,9 %), Staphylococcus coagulasa negativo (12,1%), Klebsiella
pneumoniae (12,0 %), Pseudomonas aeruginosa (11,1 %) y Staphylococcus aureus (7,2 %). Durante los dos periodos la resistencia global osciló entre 27 y 40 %. Durante la Preintervención
la resistencia osciló entre el 33 y el 39 %, mientras que durante la Intervención estuvo entre
el 27 y 40 %. Al comparar los periodos de estudio solo hubo disminución significativa de la
resistencia en los primeros nueve meses del periodo de intervención (p < 0.05).
Conclusiones: Los valores de resistencia bacteriana reportados en el periodo de intervención fueron menores que en el periodo de preintervención. Se evidenció que la revisión previa de la prescripción por parte del servicio farmacéutico en las instituciones participantes
influye en una disminución significativa de la resistencia bacteriana, pero que esta debe ser
tanto continua como incremental.
Objective: To determine the impact on bacterial resistance of the previous review of the prescription of antibiotics by the pharmaceutical service in medium and high complexity hospitals of the Department of Atlántico (Colombia). Methodology: Resistance values were analyzed for Gram-positive bacteria, Enterobacterial and non-fermenting Gram-negative bacteria reported in five health care institutions (IPS) of the Atlántico Department, in two periods (pre-intervention and intervention), of 12 months each between the months of June 2015 and May 2017. Results: During the two study periods, 68 microorganisms were identified in 8,590 microbiological isolates from urine samples (40.3 %), blood samples (21.7 %), tissues (8.5%) and others (29.5 %). The most frequently isolated microorganisms were Escherichia coli (28.9 %), Coagulase Negative Staphylococcus (12.1 %), Klebsiella pneumoniae (12.0 %), Pseudomonas aeruginosa (11.1 %) and S. aureus (7.2 %). During both periods the global resistance ranged between 27 and 40 %. During the Pre-intervention the resistance ranged between 33 and 39 %, while during the Intervention it was between 27 and 40 %. When comparing study periods, there was only significant decrease in resistance in the first nine months of the intervention period (p <0.05). Conclusions: the bacterial resistance values reported during the intervention period were lower than in the pre-intervention period. It was evidenced that the previous revision of the prescription by the pharmaceutical service in the participating institutions influences a significant decrease of the bacterial resistance; but that this must be both continuous and incremental.
Objective: To determine the impact on bacterial resistance of the previous review of the prescription of antibiotics by the pharmaceutical service in medium and high complexity hospitals of the Department of Atlántico (Colombia). Methodology: Resistance values were analyzed for Gram-positive bacteria, Enterobacterial and non-fermenting Gram-negative bacteria reported in five health care institutions (IPS) of the Atlántico Department, in two periods (pre-intervention and intervention), of 12 months each between the months of June 2015 and May 2017. Results: During the two study periods, 68 microorganisms were identified in 8,590 microbiological isolates from urine samples (40.3 %), blood samples (21.7 %), tissues (8.5%) and others (29.5 %). The most frequently isolated microorganisms were Escherichia coli (28.9 %), Coagulase Negative Staphylococcus (12.1 %), Klebsiella pneumoniae (12.0 %), Pseudomonas aeruginosa (11.1 %) and S. aureus (7.2 %). During both periods the global resistance ranged between 27 and 40 %. During the Pre-intervention the resistance ranged between 33 and 39 %, while during the Intervention it was between 27 and 40 %. When comparing study periods, there was only significant decrease in resistance in the first nine months of the intervention period (p <0.05). Conclusions: the bacterial resistance values reported during the intervention period were lower than in the pre-intervention period. It was evidenced that the previous revision of the prescription by the pharmaceutical service in the participating institutions influences a significant decrease of the bacterial resistance; but that this must be both continuous and incremental.
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Palabras clave
Resistencia a medicamentos antibacterianos, Antibióticos, Prescripciones, Servicio farmacéutico, Antibacterial drug resistance, Antibiotics, Prescriptions, Pharmaceutical services