de Frutos M, Medina R, Aragón R, López-Urrutia L, González-Sagrado M, Ramos C, Domínguez-Gil M, Garcinuño S, Viñuela L, Eiros J M
Mónica de Frutos, Hospital Universitario Río Hortega, Calle Dulzaina, 2 - Valladolid 47012, Spain.
Rev Esp Quimioter. 2019 Jun;32(3):224-231. Epub 2019 Apr 4.
Gastroenteritic salmonellosis is still the second cause diagnosed of infectious diarrhea, most of these clinical pictures are mild and self-limited and therefore the use of antibiotics is limited to few cases. The aim of the study was to describe the episodes of diarrhea caused by Salmonella enterica subsp. enterica, assessing the suitability of the request and the use of antibiotics according to the criteria included in the methodology.
A retrospective, descriptive, observational study was conducted, collecting data from the clinical history.
A total of 122 episodes were included. The reason for consultation was diarrhea, which generated a greater demand in the Hospital Emergency Services (42.6%). The most frequent serotypes isolated were Enteritidis (53.3%), and Typhimurium (40.2%). The adequate request of the stool was 90.2%. Antibiotic was prescribed in 64.6% (79) of the episodes, most patients under 65 years (58 episodes), the average age was 48.43 years. They were treated mainly with ciprofloxacin and azithromycin, in 57 and 14 episodes, respectively. The average duration of antibiotic treatment was 6 days. There was an adequate use of antibiotics in 49.1% of episodes. When the origin of the request was the Hospital Emergency Service, it was inadequate in 63.5% (33) of them. It was inadequate in 60.0% (39) of episodes when ser. Enteritidis was isolated. Almost half, 48.85% (42) of the 58 episodes in which antibiotics were prescribed among those under 65 (86), were treated without being indicated.
Training actions should be implemented focused on optimizing the management of antibiotics in this entity.
胃肠型沙门氏菌病仍是确诊的感染性腹泻的第二大病因，这些临床表现大多较轻且具有自限性，因此抗生素的使用仅限于少数病例。本研究的目的是描述由肠炎沙门氏菌亚种肠炎引起的腹泻发作情况，根据方法学中包含的标准评估申请的适宜性以及抗生素的使用情况。
进行了一项回顾性、描述性、观察性研究，从临床病史中收集数据。
共纳入122例发作病例。就诊原因是腹泻，这在医院急诊服务中产生了更大的需求（42.6%）。分离出的最常见血清型是肠炎型（53.3%）和鼠伤寒型（40.2%）。粪便送检的适宜率为90.2%。64.6%（79例）的发作病例使用了抗生素，大多数患者年龄在65岁以下（58例），平均年龄为48.43岁。他们主要接受环丙沙星和阿奇霉素治疗，分别为57例和14例。抗生素治疗的平均持续时间为6天。49.1%的发作病例抗生素使用得当。当申请来源是医院急诊服务时，其中63.5%（33例）不恰当。分离出肠炎血清型时，60.0%（39例）的发作病例不恰当。在65岁以下（86例）使用抗生素的58例发作病例中，几乎一半，即48.85%（42例）的治疗未得到指征。
应开展培训行动，重点优化该实体中抗生素的管理。
