Use of antimicrobials and cost of their prescription in a hospital specializing in nephrourological care
Keywords:
chronic kidney disease, antimicrobials, urology, ascular accessAbstract
Introduction: Infections have a higher incidence in chronic kidney disease patients than in the healthy population. On the other hand, infections associated with health care constitute a complication leading to an increase in morbidity, mortality and costs. Improper use of antibiotics is an important public health problem, for it results in the emergence of resistant bacteria.
Objective: Identify the patterns of the use of antimicrobials, determine the consumption of these agents and estimate the costs derived from their prescription.
Methods: A prospective observational study was conducted based on individual evaluations of all the 298 patients admitted. A tool was applied to subjects under antimicrobial treatment. Identification was performed of patients with infections associated with health care and cases with an inappropriate prescription of antimicrobials, and monitoring was carried out of the consumption and costs of antimicrobials.
Results: Of the total patients admitted, 122 (40.9%) were using antimicrobials. Infection was evident in 54 patients, 30 of whom had infections acquired in the community. Of these patients, 44.2% were using antimicrobials. Infection associated with health care was present in 24 patients (19.6%). In 29% of the infections diagnosed there was a predominance of gram-negative microorganisms associated with urinary tract infection in patients undergoing surgery. It was found that the cost for the use of antimicrobials was above 94 000 CUP in the four months of observation. This cost ranged between 18,829 and 27,737 CUP per month.
Conclusions: Determination of the consumption of antimicrobials and the cost of their prescription was based on the characteristics of patients attending the institution and was related to the high proportion of appropriate prescription.
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