Estudio de utilización de antimicrobianos en un servicio de cirugía general tras modificaciones en la guía farmacoterapéutica

Abstract

The use of antimicrobials is high in general surgery units. In order to optimize antimicrobials used in the treatment of intra-abdominal infection, ertapenem was included in 2007 in the formulary of the Complejo Asistencial Universitario de León. It was restricted for patients with high-severity community-acquired intra-abdominal infection or with risk factors for poor outcome, as a strategy to save antibiotics with greater spectrum (carbapenems, piperacillin/tazobactam) or as strategy of therapeutic de-escalation. Antibiotic consumption in the surgery unit was analyzed from 2006 to 2011. Defined daily doses per 100 bed-days (DBD) were calculated. We also analyze the clinical histories of patients treated with ertapenem admitted to this unit during 2011. The surgery unit has a high rate of use of antibiotics (average consumption 64.97 ± 3.98 DBD). The group of penicillins is the most consumed (average consumption 24.45 ± 2.18 DBD). It highlights the increased use of piperacillin/tazobactam and a significant decrease in the use of amiglycosides and imidazoles, parallel to the increase in the use of all carbapenems since ertapenem was introduced in the formulary. In 2011, at least in 47,4 % of cases ertapenem was used out off protocol