Publication: Estudio de la calidad de la prescripción hospitalaria de antibioterapia en la población pediátrica y propuesta de mejora con la colaboración de un farmacéutico en el equipo asistencial
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2016-11-17
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Universidad Complutense de Madrid
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Abstract
El uso incorrecto de los medicamentos ocurre en todos los países, es nocivo para los pacientes y constituye un desperdicio de recursos. Se estima que aproximadamente el 50% de los antibióticos son administrados innecesariamente. Existe una relación entre el uso indiscriminado de agentes antimicrobianos y el aumento de los microorganismos resistentes a dichos agentes. Consecuencia de ello es la aparición cada vez más frecuente de infecciones nosocomiales, cuyas responsables la mayoría de las veces, son bacterias multirresistentes. Se asocian con incidencias más elevadas de morbimortalidad, ya que limitan la opción de tratamiento por la falta de eficacia de los antibióticos, alargando el período convaleciente del paciente y encareciendo los costes del ingreso. Todo esto y el alto costo de los nuevos antibacterianos hacen que por primera vez desde la introducción de los antibióticos, exista la posibilidad de no contar con ninguna quimioterapia efectiva para los pacientes con infecciones. Este hecho es especialmente preocupante en los pacientes pediátricos, ya que por su edad se verán obligados a combatir infecciones futuras, y precisan de la mayor sensibilidad posible a los agentes antimicrobianos y de la mayor cantidad de antibióticos activos frente a ellos. Además, en los primeros años de vida se produce la mayor exposición innecesaria a antibióticos de toda la población, por ser la mayoría de las infecciones a esta edad de etiología viral y autolimitadas. Precisamente por tratarse de niños, es muy importante no olvidar que dentro del mismo Área de Pediatría existe una amplia gama de pacientes, muy diferentes unos de otros, que deben ser tratados de forma individualizada para asegurar una terapia farmacológica efectiva. La población infantil presenta diferencias farmacocinéticas y farmacodinámicas en cuanto a la respuesta a un fármaco, lo cual hace de la farmacología pediátrica una especialidad en sí misma. A día de hoy, los estudios sobre pacientes pediátricos son más bien escasos. Este trabajo podría resultar de gran utilidad para ampliar y enriquecer estos conocimientos...
Misuse of drugs takes place in all countries; it is harmful to patients and a waste of resources. It is estimated that approximately 50% of antibiotics are administered unnecessarily. There is a relationship between the indiscriminate use of antimicrobial agents and the increase of the microorganisms resistant to said agents. A result of this is the increasingly frequent appearance of nosocomial infections caused, more often than not, by multidrug-resistant bacteria. They are associated with higher incidences of morbidity and mortality as they limit the choice of treatment due to the lack of antibiotic effectiveness, subsequently lengthening the patient’s convalescent period and increasing costs of the patient́s hospital residence. The overall consequence of the forementioned issues on top and the high cost of new antibacterial agents brings about the possibility of not attaining effective chemotherapy for infected patients for the first time since the introduction of antibiotics. This is particularly worrying in pediatric patients; due to their age they will be forced to fight future infections, and will require a greater sensitivity to antimicrobial agents and the maximum number of antibiotics actively fighting these infections. Moreover, most of the entire population’s unnecessary exposure to antibiotics occurs in the early years of life. This is because the majority of the infections in this age period are due to viral etiology and are self-limiting. Precisely because we are dealing with children, it is very important not to forget that within the same area of pediatric department there is a wide range of patients, very different from each other, that must be treated on an individual basis to ensure an effective pharmacological therapy. The child population presents differences in pharmacokinetics and pharmacodynamics in terms of the response to a drug, which makes pediatric pharmacology a medical specialty in itself. To date, studies on pediatric patients are rather scarce. This work could be useful to expand and enrich the existing knowledge on this subject...
Misuse of drugs takes place in all countries; it is harmful to patients and a waste of resources. It is estimated that approximately 50% of antibiotics are administered unnecessarily. There is a relationship between the indiscriminate use of antimicrobial agents and the increase of the microorganisms resistant to said agents. A result of this is the increasingly frequent appearance of nosocomial infections caused, more often than not, by multidrug-resistant bacteria. They are associated with higher incidences of morbidity and mortality as they limit the choice of treatment due to the lack of antibiotic effectiveness, subsequently lengthening the patient’s convalescent period and increasing costs of the patient́s hospital residence. The overall consequence of the forementioned issues on top and the high cost of new antibacterial agents brings about the possibility of not attaining effective chemotherapy for infected patients for the first time since the introduction of antibiotics. This is particularly worrying in pediatric patients; due to their age they will be forced to fight future infections, and will require a greater sensitivity to antimicrobial agents and the maximum number of antibiotics actively fighting these infections. Moreover, most of the entire population’s unnecessary exposure to antibiotics occurs in the early years of life. This is because the majority of the infections in this age period are due to viral etiology and are self-limiting. Precisely because we are dealing with children, it is very important not to forget that within the same area of pediatric department there is a wide range of patients, very different from each other, that must be treated on an individual basis to ensure an effective pharmacological therapy. The child population presents differences in pharmacokinetics and pharmacodynamics in terms of the response to a drug, which makes pediatric pharmacology a medical specialty in itself. To date, studies on pediatric patients are rather scarce. This work could be useful to expand and enrich the existing knowledge on this subject...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Farmacología (Farmacognosia y Farmacología Experimental), leída el 29/02/2016