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La epidemiología del uso de vancomicina intravenosa en un hospital universitario. Un estudio de estudio de 10 años
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242.
JAMA
|February 3, 1993
Resumen
El uso de vancomicina aumentó 20 veces en una década, impulsado por dispositivos vasculares permanentes en pacientes de hematología-oncología. Su uso se divide por igual entre la terapia empírica, profiláctica y dirigida.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
- Farmacología Farmacología.
Sus antecedentes:
- La vancomicina intravenosa es un antibiótico crítico para el tratamiento de infecciones graves.
- Comprender las tendencias y los predictores del uso de la vancomicina es esencial para la administración antimicrobiana.
Objetivo del estudio:
- Para analizar la tendencia de 10 años en el uso de vancomicina intravenosa.
- Para categorizar las indicaciones para la prescripción de vancomicina.
- Para identificar predictores independientes para el uso empírico de la vancomicina.
Principales métodos:
- Un estudio epidemiológico descriptivo de 10 años (1981-1991) en un hospital docente universitario.
- Los estudios transversales y de casos y controles evaluaron las indicaciones y los predictores de la vancomicina.
- El análisis multivariado identificó los determinantes del uso empírico de la vancomicina.
Principales resultados:
- El uso de vancomicina aumentó 20 veces (de 5,72 a 121,25 g/1000 días-paciente).
- El uso fue más alto en hematología-oncología (P < .0001).
- Las indicaciones fueron la profilaxis (35,0%), la terapia empírica (31,8%) y la terapia dirigida (33,2%).
- Los dispositivos vasculares permanentes (líneas intravenosas, catéteres de Hickman) fueron fuertes predictores para el uso de vancomicina.
Conclusiones:
- El uso de vancomicina aumentó significativamente durante la década, vinculado a dispositivos vasculares permanentes.
- Los pacientes de hematología-oncología mostraron una mayor utilización de la vancomicina.
- Las recetas de vancomicina se distribuyeron por igual entre la terapia empírica, profiláctica y dirigida.
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