Résumé
ABSTRACT OBJECTIVE To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials. METHODS A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II). RESULTS The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006-0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003-0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05). CONCLUSIONS The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.
RESUMO OBJETIVO Avaliar se a incidência de infecção hospitalar por microrganismo resistente diminuiu após a implementação da medida restritiva da Agência Nacional de Vigilância Sanitária para comercialização de antimicrobianos. MÉTODOS Estudo de coorte histórica de registros de prontuários de pacientes adultos admitidos para internação em um hospital geral e público no período de maio de 2010 a julho de 2011. Foi formada uma coorte com pacientes internados em período anterior à medida restritiva para comercialização de antimicrobianos (Fase I) e uma segunda coorte com pacientes admitidos após a implantação da medida restritiva (Fase II). RESULTADOS O risco instantâneo de infecção hospitalar por microrganismo resistente foi estimado em sete por 1.000 pessoas-tempo (IC95% 0,006-0,008) na Fase I, e quatro por 1.000 pessoas-tempo (IC95% 0,003-0,005) na Fase II do estudo. As diferenças entre as curvas de sobrevida nas diferentes fases do estudo e estratificadas pela faixa etária também foram significativas (p < 0,05). CONCLUSÕES Os resultados sugerem que a implantação da medida restritiva de comercialização de antimicrobianos pela Agência Nacional de Vigilância Sanitária reduziu a incidência de infecção hospitalar por microrganismo resistente.
Sujets)
Humains , Mâle , Femelle , Résistance microbienne aux médicaments , Infection croisée/prévention et contrôle , Infection croisée/traitement médicamenteux , Abus de médicaments sur ordonnance/législation et jurisprudence , Antibactériens/administration et posologie , bêta-Lactamases/effets des médicaments et des substances chimiques , Brésil , Études de cohortes , Prévention des infections/méthodes , Surveillance des médicaments , Utilisation médicament/législation et jurisprudence , Abus de médicaments sur ordonnance/effets indésirables , Abus de médicaments sur ordonnance/statistiques et données numériques , Adulte d'âge moyenRésumé
Abstract: Methotrexate is one of the most used drugs in the treatment of psoriasis with indication of systemic therapy. Cutaneous and mucous side effects are described by pharmacological characteristics of the drug itself or due to overdose. We report the case of a patient with ulcerations in oral mucosa and psoriatic plaques after incorrect use of Methotrexate. Prescribed in a weekly dose, it was used continuously for 10 days and without simultaneous intake of folic acid. It is important to ensure correct comprehension of the prescription.