Analysis of the use of antimicrobials in elderly patients hospitalized in a military hospital in Belém-PA
DOI:
https://doi.org/10.33448/rsd-v10i13.21319Keywords:
Antimicrobials; Elderly; Public health.Abstract
According to the World Health Organization, population aging is one of the greatest challenges facing society. The discovery of antimicrobials (ATM) positively transformed clinical practice, however, the WHO highlights the growing emergence of resistant pathogens to these. The present study sought to analyze the use of ATMs in elderly patients hospitalized in a military hospital in Belém-PA, as well as the identification of possible problems related to these. Twelve patients were included in the study, who had a mean hospital stay of 36.6 days and 11 different antimicrobials prescribed. Of these, 89.7% prescriptions had adequate indication, dose in 84.5% and duration of treatment in 55.2%. After analyzing the tracers, it was identified that 3 patients had adverse drug reactions (ADR). The presence of patients with inadequate prescription of TMJ, regarding the indication, dose and duration of treatment, may be related to the absence of adequate therapeutic protocols for their use and administration. Thus, intensive monitoring of TMJ use in the elderly population in a hospital environment is extremely important, seeking to avoid the emergence of ADRs, which are often responsible for the worsening of the clinical condition of these patients and unnecessary expenses. Finally, it is important to highlight those further studies with a larger number of individuals are needed, to prove or not, the inappropriate use of these drugs in this population.
References
Ayres, M., Ayres Jr, M., Ayres, L. D., & Santos, S. A. A. (2007). BioEstat 5.0.: aplicações estatísticas nas áreas das Ciências Biomédicas. Sociedade Civil Mamirauá: Belém, Pará-Brasil. 324p. Aplicações estatísticas nas áreas das ciências biomédicas. Ong Mamirauá. Belém, PA.
Brasil. (2016). Agência Nacional de Vigilância Sanitária. Programa Nacional de Prevenção e Controle de Infecções Relacionadas à Assistência à Saúde.
Chastre, J., & Fagon, J. Y. (2002). Ventilator-Associated Pneumonia. State of The Art. Am J Respir Crit Care Med. v. 165, n 7, p. 867-903. https://doi.org/10.1164/ajrccm.165.7.2105078.
Cortés, S. D. C. (2016). Busca de reações adversas a medicamentos em pacientes internados em Clínica Médica usando rastreadores. Dissertação (Mestrado) – Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo.
Carneiro, M., Ferraz, T., Bueno, M., Koch, E. B., Foresti, C., Lena, F. V., Machado, A. J., Rauber, M. J., Krummenaauer, C. E., & Lazaroto, M. D. (2011). O uso de antimicrobianos em um hospital de ensino: uma breve avaliação. Revista da Associação Médica Brasileira. Volume 57, Issue 4, Pages 421-424. https://doi.org/10.1590/S0104-42302011000400016.
De With, K., Allerberger, F., Amann, S. et al. (2016). Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases. Infection 44, 395–439 (2016). https://doi.org/10.1007/s15010-016-0885-z
Gallelli, L., Ferreri, G., Colosimo, M., Pirritano, D., Guadagnino, L., Pelaia, G., Maselli, R., & De Sarro, G. B. (2002). Adverse drug reactions to antibiotics observed in two pulmonology divisions of catanzaro, Italy: a six-year retrospective study. Pharmacol Res.46(5):395-400. doi:https://10.1016/s1043661802002104. PMID: 12419643.
Giordani, F. Rozenfeld, S. Gelena, O. M. F. D., & Joelma, V. S. G. L. (2012). Suto TerencioLuciane de Fátima CaldeiraLuiz Carlos Gonçalves de Andrade. Vigilância de eventos adversos a medicamentos em hospitais: aplicação e desempenho de rastreadores. Rev Bras Epidemiol. v.15, n. 3, p. 455-67. https://doi.org/10.1590/S1415-790X2012000300002.
Instituto Brasileiro de Geografia e Estatística (IBGE). (2017). Tábua completa de mortalidade para o Brasil – 2017: breve análise da evolução da mortalidade no Brasil. Rio de Janeiro: IBGE, 2018. 28 p.
Kollef, M. (2000). Inadequate antimicrobial treatment: an important determinant of outcome for hospitalized patients. CID. v. 31, n. suppl_4, p. 131-8. https://doi.org/10.1378/chest.115.2.462.
Krahenbuhl-Melcher, A., et al. (2007). Drug-related problems in hospital: a review of the recente literature. Drug Saf. v.30, n. 5, p. 379-407, 2007. https://doi.org/10.2165/00002018-200730050-00003
Larson, E. L., Quiros, D., Giblin, T., & Lin, S. (2007). Relationship of antimicrobial control policies and hospital and infection control characteristics to antimicrobial resistance rates. American journal of critical care : an official publication, American Association of Critical-Care Nurses, 16(2), 110–120. http://dx.doi.org/10.4037/ajcc2007.16.2.110.
Lin, Y. F., Yang, C. H., Sindy, H., Lin, J. Y., Rosaline, C. Y. H., Tsai, Y. C., Wu, T. S., Huang, C. T., Kao, K. C., Hu, H. C., Chiu, C. H., Hung, S. I., & Chung, W. H. (2014). Severe cutaneous adverse reactions related to systemic antibiotics. Clin Infect Dis. (10):1377-85. https://doi.org/10.1093/cid/ciu126.
Maues, C. R., et al. (2007). Epidemiologia de idosos internados na enfermaria de clínica médica de hospital público. Rev. Para. Med., Belém, v. 21, n. 3, p. 31-36, set. 2007. Disponível em <http://scielo.iec.gov.br/scielo.php?script=sci_arttext&pid=S0101-59072007000300005&lng=pt&nrm=iso>. acessos em 15 jun. 2021.
Menezes, C. R. (2013). Monitorização do uso de ATM como estratégia de combate à resistência bacteriana em uma UTI de adultos. Dissertação (Mestrado) - Instituto de Ciências Biológicas, Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, 2013.
Micromedex. Hipersensibilidade à Vancomicina. Disponível em: <http://www.thomsonhc.com/hsc/librarian/ND_PR//Main/SBK/1/PFPUI/wr1ap9G2KxXLz5/ND_PG/PRIH/CS/EE8D40/ND_T/HCS/ND_P/Main/DUPLICATIONSHIELDSYNC/325FE7/ND_B/HCS/PFActionld/hcs.common.RetrieveDocumentCommon?Docld/177c/ContentSetld//30/SearchTerm/VANCO/SearchOption/BeginWith>. Acesso em 18-03-2021.
Naranjo, C. A., & Busto, U. (1991). Reações Adversas às Drogas. In: KALANT, H.; ROSCHLAU, W.H.E. Princípios de Farmacologia Médica. Rio de Janeiro: Guanabara Koogan. p.537-542.
Naranjo, C. A., et al. (1981). A Method for estimating the probability of adverse drug reactions. Clinical. Pharmacology & Therapeutics. v. 30, n. 2, p.239-245.
Organização Mundial da Saúde. (2005). Envelhecimento ativo: uma política de saúde. Brasília, OPAS; 2005.
Passarelli, M. C., Filho, W. J., & Figueras, A. (2007). Adverse drug reactions in a elderly hospitalized population: inappropriate prescription is a leading cause. Drugs Aging. v. 22, n. 9, p. 767-77. https://doi.org/10.2165/00002512-200522090-00005.
Passarelli, M. C. G., Filho, W. F. (2007). Reações Adversas a Medicamentos em Idosos: Como Prevê-las? Einstein. São Paulo, v. 5, n. 3, p. 246 – 251.
Queiroz, M. U. N. (2010). Farmacovigilância: monitorização intensiva de vancomicina em pacientes hospitalizados. Dissertação (Mestrado em Medicamentos e Cosméticos) – Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo; 2010. doi:https://10.11606/D.60.2010.tde-29032012-110351.
Rabelo, L. P. O., Vieira, M. A., Caldeira, A. P., Costa, S. M. (2010). Perfil de idosos internados em um hospital universitario / Perfil de ancianos hospitalizados en un hospital universitario / Profile of elderly hospitalized in a university hospital. REME. V. 14, n. 3, p. 293-300.
Rozenfeld, S., Giordani, F., Coelho, S. (2013). Eventos adversos a medicamentos em hospital terciário: estudo piloto com rastreadores. Revista de Saúde Pública, 47(6),1102-1111.[acessado em 11 de outubro de 2021]. ISSN: 0034-8910. Disponível em: https://www.redalyc.org/articulo.oa?id=67240209009
Souza, N., Oliveira, G., Girão, A., Souza, L., Maniva, S., & Freitas, C. (2015). Adoecimento por hipertensão arterial e Diabetes Mellitus: concepções de um grupo de pacientes hospitalizados [Conceptions of illness from hypertension and Diabetes Mellitus among a group of hospital inpatients]. Revista Enfermagem UERJ, 23(1), 52-57. doi:https://doi.org/10.12957/reuerj.2015.15579
Spiandorello, W. P., et al. (2006). Use of multiple antimicrobial drugs by clinical patients: a prognostic index of hospital mortality? Clinics. v. 61, p 15-20. https://doi.org/10.1590/S1807-59322006000100004.
Teixeira, J. J. M., et al. (2017). Perfil de internação de idosos. Rev Soc Bras Clin Med. v. 15, n 1, p. 15-20.
Who, et al. (2019). Antimicrobial stewardship programmes in health-care facilities in low-and middle-income countries: a WHO practical toolkit. 2019. Disponível em: <https://apps.who.int/iris/bitstream/handle/10665/329404/9789241515481-eng.pdf?sequence=1&isAllowed=y>
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Copyright (c) 2021 Ariana Cristina de Oliveira Azulino ; Edilberto Pontes Garcia Júnior ; Keith Brabo Feitosa Tavares; Adriana Vieira Coelho; Priscila Pessoa Diamantino Reis; Bruna Hogla Rodrigues Afonso; Thasmyr das Mercês Gonçalves Corrêa; Gabriel da Silva Duarte; Francisco Daniel Queiroz Brito; Alessandra Ribeiro Moraes da Silva; José Eduardo Gomes Arruda
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