Laguna P, Moya M S, García F, Salgado R, Calabrese S
Servicio de Urgencias, Clínica Puerta de Hierro, Madrid.
Rev Clin Esp. 1996 Jul;196(7):431-6.
To know the frequency of antibiotic prescription, the conditions that motivate their usage, and to evaluate the quality of such therapies in a hospital emergency department (HED).
Retrospective study of 2,677 patients attended at a HED for a one-month period including those who had antibiotics prescribed in the discharge report. The parameters used to evaluate the therapeutic quality included the condition amenable to antibiotic therapy, appropriate antibiotic, dosage, interval of administration, and duration. Each parameter had a score which was used to quantitate the quality in a 0 to 100 scale.
A total of 288 patients (10.7%) had antibiotics prescribed for treatment of respiratory tract infections (53.8%) and urinary tract infections (19.4%). The antibiotic group that accounted for most prescriptions was broad-spectrum penicillins (45%), followed by quinolones (12.8%), and urinary antiseptics (11.4%). Only 100 (50.3%) treatments were considered correct for all parameters analyzed. The most inadequate parameters were: non-appropriate antibiotic in 17.1% of cases and incorrect length of administration in 39.9%. The average quality according to scale was 89.6 (SD = 20.3). A lower quality was observed for treatments prescribed when on duty compared with normal working time (p = 0.006).
Antibiotics are drugs frequently prescribed in HED. Errors were detected in choosing antibiotic therapies and antibiotic course duration in our department, which makes the adoption of intervention measures for its correction necessary.