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La provisión de la profilaxis neumocócica para los niños asegurados públicamente con la anemia de células falciformes

Colin M Sox¹, William O Cooper, Thomas D Koepsell

¹Department of Pediatrics, University of Washington, Seattle 98195-7183, USA. colinsox@u.washington.edu

|August 28, 2003

Resumen

Los niños con enfermedad de células falciformes (ECF) a menudo reciben una profilaxis antibiótica insuficiente, lo que aumenta los riesgos de infección. Las visitas de cuidado preventivo se correlacionan con una mejor administración de medicamentos para estos niños vulnerables.

Área de la Ciencia:

Enfermedades infecciosas pediátricas.
Hematología Hematología.
Salud pública La salud pública es la salud pública.

Sus antecedentes:

Los niños menores de 5 años con enfermedad de células falciformes (ECF) requieren antibióticos profilácticos diarios para prevenir las infecciones por neumococos.
La cantidad real de medicamentos profilácticos dispensados a estos niños sigue sin estar clara.

Objetivo del estudio:

Para cuantificar la dispensación profiláctica de antibióticos para niños pequeños con SCD.
Identificar los factores que influyen en la administración de estos medicamentos esenciales.

Principales métodos:

Estudio longitudinal retrospectivo utilizando las reclamaciones administrativas de Medicaid de Tennessee y el estado de Washington (1995-1999).
Incluido 261 niños menores de 4 años con SCD, continuamente inscritos en Medicaid durante un año.
Días medidos cubiertos por recetas para antibióticos específicos durante un período de 365 días.

Principales resultados:

Los pacientes recibieron una media de 148,4 días de medicación profiláctica al año, con una amplia variación (10,3% no recibió ninguno, 21,5% recibió >270 días).
Se llenaron una media de 12,7 recetas por paciente al año, con una duración media de 10 días.
Cada visita preventiva estuvo vinculada a 12,0 días adicionales de antibióticos, y cada visita de ED a 10,0 días adicionales.

Conclusiones:

Los niños asegurados públicamente con SCD pueden tener una profilaxis antibiótica inadecuada, aumentando los riesgos de morbilidad y mortalidad por infección neumocócica.
El aumento de las visitas de atención preventiva ambulatoria está asociado con una mejor provisión de profilaxis antibiótica en niños con ECS.

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