Evaluación del uso de antibióticos e impacto de una intervención dirigida a modificar la conducta prescriptiva en profilaxis quirúrgica en 6 hospitales del área metropolitana de Monterrey

Palacios-Saucedo, Gerardo del Carmen; Garza-Camargo, Mauricio de la; Briones-Lara, Evangelina; Carmona-González, Sandra; García-Cabello, Ricardo; Islas-Esparza, Luis Arturo; Saldaña-Flores, Gustavo; González-Cano, Juan Roberto; González-Ruvalcaba, Román; Valadez-Botello, Francisco Javier; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantú, Carlos Alberto; Díaz-Ramos, Rita Delia; Solórzano-Santos, Fortino

doi:10.1016/j.circir.2016.10.033

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…Twenty-one out of 31 studies focused on safety checklists (including safe birthing checklists),31 32 five on SSI/AMS,33 34 one on ERAS35 and four36 37 38 on other interventions (table 1). The latter included implementation of guidelines to improve obstetric care, increase vaginal delivery rate by increasing access to neuraxial analgesia, management guidelines, multifaceted educational activities and a package of QI activities at intervention sites (online supplemental appendix 2 provides a summary of each study).…”

Section: Resultsmentioning

confidence: 99%

Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

et al. 2022

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BackgroundGlobally, 5 billion people lack access to safe surgical care with more deaths due to lack of quality care rather than lack of access. While many proven quality improvement (QI) interventions exist in high-income countries, implementing them in low/middle-income countries (LMICs) faces further challenges. Currently, theory-driven, systematically articulated knowledge of the factors that support successful scale-up of QI in perioperative care in these settings is lacking. We aimed to identify all perioperative safety and QI interventions applied at scale in LMICs and evaluate their implementation mechanisms using implementation theory.MethodsSystematic scoping review of perioperative QI interventions in LMICs from 1960 to 2020. Studies were identified through Medline, EMBASE and Google Scholar. Data were extracted in two phases: (1) abstract review to identify the range of QI interventions; (2) studies describing scale-up (three or more sites), had full texts retrieved and analysed for; implementation strategies and scale-up frameworks used; and implementation outcomes reported.ResultsWe screened 45 128 articles, identifying 137 studies describing perioperative QI interventions across 47 countries. Only 31 of 137 (23%) articles reported scale-up with the most common intervention being the WHO Surgical Safety Checklist. The most common implementation strategies were training and educating stakeholders, developing stakeholder relationships, and using evaluative and iterative strategies. Reporting of implementation mechanisms was generally poor; and although the components of scale-up frameworks were reported, relevant frameworks were rarely referenced.ConclusionMany studies report implementation of QI interventions, but few report successful scale-up from single to multiple-site implementation. Greater use of implementation science methodology may help determine what works, where and why, thereby aiding more widespread scale-up and dissemination of perioperative QI interventions.

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Section: Resultsmentioning

confidence: 99%

Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

et al. 2022

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“…The irrational use of antibiotic therapy will increase the occurrence of resistance, which impacts the increase of morbidity, mortality, and health costs Worldwide, irrational use of antibiotics is escalating, both in developed and developing countries. 10,13,24,25 Irrational use of antibiotics can take many forms, including the prolonged antibiotics use, 13 restricted antibiotics use, 12 outside clinical guidelines, 13,14 inappropriate timing/ duration of prophylactic or therapeutic antibiotic administration, 10,24,25 or with inadequate dosage or inappropriate route of administration. 12 As a direct consequence of irrational antibiotic use, resistance to the commonly available antibiotics has been increasing rapidly.…”

Section: Discussionmentioning

confidence: 99%

“…Inappropriate use of surgical prophylactic antibiotics has been widely reported. 10,[12][13][14][15] If the antibiotics used in surgical patients are inappropriate, there will be a risk of resistance. Therefore, monitoring the use of prophylactic and empiric antibiotics in surgical patients is necessary.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of patients associated with antibiotic use among gastrointestinal surgery at the Academic Hospital, Universitas Gadjah Mada

Saskiya,

Taufiqurohman,

Wiedyaningsih

2024

InaJBCS

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Digestive surgery is a treatment for diseases of the parts of the body involved in digestion, which has a fairly high risk of infection. The study aimed to obtain a description of the types and specific characteristics of patients and the rationality of antibiotic use among digestive surgery patients. This study was conducted using observational analysis. Data on antibiotic use was collected prospectively from medical records of digestive surgery inpatients at the Academic Hospital Universitas Gadjah Mada (UGM) from January to March 2023. The Gyssens method was used to evaluate qualitatively the use of antibiotics. A total of 76 patients met the inclusion and exclusion criteria. No significant difference between the number of male and female patients was identified. The results showed that 24 (31.58%) acute appendicitis patients are the primary diagnosis most often encountered in patients undergoing digestive surgery. The most frequently used prophylactic antibiotics for digestive surgery patients were ceftriaxone (53.85%) and cefazolin (41.03%). Meanwhile, the most frequently used therapeutic antibiotics were ceftriaxone (41.94%) and levofloxacin (29.03%). The Gyssens analysis shows that large irrational use of antibiotics is still observed.

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“… 19 Even after a multi-centric improvement initiative, inappropriate prophylaxis regimens were found in 75.3% of surgical patients, and inappropriate dosages in 51.2%. 20 To date, in spite of this worrisome panorama, there are not official programs to analyze and improve the patterns of antibiotic use in Mexico. Besides, comprehensive studies on the characteristics of antimicrobial prescription and use are also lacking.…”

Section: Introductionmentioning

confidence: 99%

Point Prevalence Survey of Antimicrobial Use in Four Tertiary Care Hospitals in Mexico

Zumaya-Estrada¹,

Ponce-De-León-Garduño²,

Ortíz-Brizuela³

et al. 2021

IDR

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Evaluación del uso de antibióticos e impacto de una intervención dirigida a modificar la conducta prescriptiva en profilaxis quirúrgica en 6 hospitales del área metropolitana de Monterrey

Cited by 7 publications

References 23 publications

Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness

Characteristics of patients associated with antibiotic use among gastrointestinal surgery at the Academic Hospital, Universitas Gadjah Mada

Point Prevalence Survey of Antimicrobial Use in Four Tertiary Care Hospitals in Mexico

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