Consumo de antibacterianos en tres hospitales de Santiago de Cuba en el período 2019-2020

Context: Infections by multiresistant bacteria increase the risk of therapeutic failure, increasing hospital stay, costs and mortality. This determines the use of more expensive antibacterials with a broader spectrum, which leads to a high consumption at the hospital level, which increases bacterial resistance. Aims: To characterize the consumption of antibacterials in three hospitals in Santiago de Cuba. Methods: A descriptive and cross-sectional study of consumption was carried out. The consumed units, anatomical, therapeutic, and chemical classification, route of administration and price were analyzed for each antimicrobial. The defined daily dose (DDD)/100 beds/day and the cost of antibacterials for systemic use were determined. Descriptive statistics were used. Results: The most used antibacterial in both years (2019 and 2020) was ceftriaxone (12.6% and 26.9%). The most used group was J01D (39.5% and 44.8%), mainly parenteral via. In 2019 they presented higher DDD/100 beds/day: gentamicin (38.74 in the General Hospital and 20.20 in the Maternal Hospital) and ciprofloxacin (31.51 in the General Hospital and 15.00 in the Oncology Hospital); and in 2020 it was cefazolin (41.42 in General Hospital), ciprofloxacin (17.73 in Oncology) and gentamicin (26.99 in Maternal). The highest total costs were for ciprofloxacin and ceftriaxone. Conclusions: The increase in consumption evidenced the need to update therapeutic policies and validation of prescriptions for this group of drugs.

[Pharmacological strategies to improve the adherence to highly active antiretroviral therapy]

BACKGROUND

adherence to antiretroviral therapy is an important factor in achieving human immunodeficiency virus suppression. The aim was to apply a pharmacological strategy, based in pharmacokinetics measures for improving the adherence to antiretroviral therapy.

METHODS

We did a descriptive study for eight months in 75 human immunodeficiency virus positive patients with clinical and social criteria for highly active antiretroviral therapy in Opuwo, Namibia. Pharmacological aspects, such as major side effects and dangerous drug-drug interactions, were evaluated. Descriptive statistics analysis were applied.

RESULTS

three minor side effects were detected (two for efavirenz and one for nevirapine), and one major side effect for stavudine/lamivudine. Dangerous drug interactions were avoided doing pharmacokinetics measures with efavirenz, stavudine/lamivudine and zidovudine; and between nevirapine and fluconazol or ketoconazol.

CONCLUSIONS

the adherence to highly active antiretroviral therapy was improved with the application of the proposed pharmacological strategy to avoid side effects and dangerous drug interactions.

[Thin layer chromatography and infrared spectroscopy in the diagnosis of salicylic intoxication]

Drugs are the main causal agents in intoxications with suicidal purpose. Salicylates are few frequently related. In this paper we reported a patient with suspicion of acute exogenous intoxication with salicylates. The patient showed clinical symptoms of fever, hypoglycemia, low cardiac rhythm, hyperventilation, pulmonary edema and coma. We employed analytical toxicology to elucidate the drug involved in the intoxication, using thin layer chromatography (TLC) and infrared spectrometry to detect acetyl salicylic acid, as the cause agent of intoxication clinical pattern, in acids extracts from urine and gastric content. The analytical results corresponds with clinical symptoms showed by the patient and the information obtained by medical monitoring of him.