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Antibióticos profilácticos en la cirugía. Prácticas dentro de los servicios quirúrgicos de la Administración de
JAMA
|February 16, 1979
Resumen
Una encuesta sobre la prescripción de antibióticos profilácticos en los hospitales de la Administración de Veteranos encontró desviaciones significativas de las pautas de expertos, siendo el uso excesivo el problema principal. La mayoría de los cirujanos están abiertos a la retroalimentación de auditoría formal para mejorar las prácticas de prescripción.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Práctica quirúrgica Práctica quirúrgica
- Servicios de salud Servicios de salud Investigación Investigación.
Sus antecedentes:
- El uso profiláctico de antibióticos es estándar en cirugía, pero requiere el cumplimiento de las pautas.
- Las variaciones en los hábitos de prescripción pueden conducir a resultados subóptimos y resistencia a los antimicrobianos.
- La Administración de Veteranos (VA) estableció directrices expertas para el uso de antimicrobianos.
Objetivo del estudio:
- Evaluar las prácticas actuales de prescripción profiláctica de antibióticos entre los jefes quirúrgicos en el VA.
- Para comparar estas prácticas con las directrices establecidas por el comité de expertos de VA.
- Identificar las áreas de no conformidad y las posibles intervenciones.
Principales métodos:
- Se distribuyó una encuesta a los jefes de los servicios quirúrgicos en todo el sistema de VA.
- La tasa de respuesta lograda fue del 99%.
- Los hábitos de prescripción se compararon con las directrices del comité de expertos de la oficina central de VA.
Principales resultados:
- El hospital promedio logró una puntuación de concordancia del 62,4% con las pautas de expertos, lo que indica una brecha significativa.
- La mayoría de los errores de prescripción involucraron el uso excesivo de antibióticos, no el uso insuficiente.
- El tamaño del hospital y la afiliación universitaria no se correlacionaron con la adherencia a la prescripción.
Conclusiones:
- Existen oportunidades significativas para mejorar la prescripción profiláctica de antibióticos dentro de los servicios quirúrgicos de VA.
- Las auditorías formales y los mecanismos de retroalimentación, en lugar de las rondas informales, pueden ser más efectivas.
- Los principales cirujanos expresaron su voluntad de adoptar directrices basadas en auditorías, sugiriendo un camino para la mejora.
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