• Cir Cir · Nov 2017

    Multicenter Study

    [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].

    • Gerardo Del Carmen Palacios-Saucedo, Mauricio de la Garza-Camargo, Evangelina Briones-Lara, Sandra Carmona-González, Ricardo García-Cabello, Luis Arturo Islas-Esparza, Gustavo Saldaña-Flores, Juan Roberto González-Cano, Román González-Ruvalcaba, Francisco Javier Valadez-Botello, Gerardo Enrique Muñoz-Maldonado, Carlos Alberto Montero-Cantú, Rita Delia Díaz-Ramos, and Fortino Solórzano-Santos.
    • Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México. Electronic address: palsaugc@gmail.com.
    • Cir Cir. 2017 Nov 1; 85 (6): 459-470.

    BackgroundImproper use of antibiotics increases antimicrobial resistance.ObjectiveEvaluate 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 MethodsDesign: 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.AnalysisFrequencies, percentages, medians, ranges and X2 test.ResultsPhase 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).ConclusionsInappropriate 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.

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