Uso, consumo y costo de medicamentos antimicrobianos controlados en dos servicios del hospital universitario "General Calixto García" / Use, consume and cost of controlled antimicrobials in two services at"Calixto Garcia" University Hospital

Introducción: el uso irracional de antimicrobianos es un problema de salud a nivel mundial, tanto por las implicaciones médicas para los pacientes como por los elevados costos asistenciales. Un número elevado de pacientes recibe terapia antimicrobiana, siendo necesaria la prescripción atinada del fármaco, teniendo en cuenta la dinámica de la ecología bacteriana, la individualidad de cada enfermo y la significación de los costos a nivel institucional y del país. Objetivo: determinar la utilización, el consumo y el costo de los medicamentos antimicrobianos controlados en dos servicios hospitalarios. Material y Métodos: se realizó un estudio exploratorio, observacional, transversal, sobre el uso de los medicamentos antimicrobianos y su costo. El universo estuvo constituido por todos los pacientes que consumieron medicamentos antimicrobianos controlados y autorizados por la Comisión de Antibióticos acreditada para tales efectos, en las salas de Medicina Interna y Terapia Intensiva del Hospital Calixto García, en el período comprendido de junio a noviembre de 2010. Resultados: los medicamentos antimicrobianos más utilizados fueron las cefalosporinas, principalmente la cefuroxima con 4 514 bulbos en las salas de Medicina Interna y la ceftriaxona con 5 982 bulbos en el servicio de Terapia Intensiva. El gasto general por concepto de antimicrobianos consumidos fue elevado (432 914,00 MN), siendo el servicio de Terapia Intensiva el responsable del mayor gasto (312 528,80 MN). Conclusiones: las cefalosporinas constituyeron el grupo farmacológico más empleado en ambos servicios, además de que hubo un mayor consumo de aminoglucósidos y vancomicina en el Servicio de Terapia Intensiva, donde los gastos fueron mayores.

Introduction: the irrational use of antimicrobials is a common health problem world around, having impact on both medical applications and high costs. A large number of patients receive antimicrobial therapy, for which is convenient the correct drug prescription, taking into account dynamics of the bacterial ecology, the peculiarities of each patient and the local and national costs of the medications. Objective: to characterize controlled antimicrobials according to consumeand costs at the Internal Medicine and Intensive Care Unit of theCalixto Garcia Hospital. Material and Methods: the present paper shows a descriptive, observational and retrospective study of Drug Use based on the analysis of consume and costs. The studied considered all patients that consumed controlled antimicrobials at the Internal Medicine and Intensive Care services of the Calixto Garcia Hospital during June to November of 2010 and whose use was authorized by the Antibiotic Commission accredited or such ends. Results: the most used antimicrobials were the cefalosporins amily with 4514 bulbs, mainly Cefuroxima, at the Internal Medicine service, while and Ceftriaxona with 5982 bulbs was the most used in the Intensive care service. The overall cost caused by consumption of antimicrobials was high (432914.00 pesos), mostly at the Intensive Care service (312528.80 pesos). This was related to the high consume of ciprofloxacine (39387.70 and 70656.30 pesos) in the Internal Medicine and Intensive Care Unit. Conclusions: the cephalosporins was the pharmacology group most used in both services, the consume of aminoglycoside and vancomycin was quarter in intensive care Unit, where the costs were higher.

Utilización de azitromicina en el área de salud Mártires de Calabazar. 2008 / Utilization of azitromicin in Mártires de Calabazar Primary health atention clinical. 2008

Los estudios de utilización de medicamentos (EUM) en sus diferentes tipos, analizan la comercialización, distribución, prescripción y uso de los medicamentos en una sociedad, con el objetivo de identificar problemas en su utilización y factores condicionantes de los mismos. Se realizó un EUM de tipo prescripción-indicación con elementos de consumo y esquema terapéutico en el que se evaluó la utilización de Azitromicina disponible en las cuatro farmacias del área de salud Mártires de Calabazar, municipio Boyeros, durante 3 meses del año 2008. Se revisaron las recetas prescriptas de este antimicrobiano durante el período de estudio, con el propósito de evaluar la prescripción teniendo en cuenta las indicaciones y la dosis total ordenada en las mismas. Los resultados más importantes incluyen que el consumo de Azitromicina en el área en el año 2008 fue de 2 DHD (Dosis Diaria Definida por 1 000 habitantes por Día). Las infecciones del aparato respiratorio fueron el motivo de prescripción más frecuente y más de la cuarta parte de las dosis prescriptas de Azitromicina fueron incorrectas. Se concluyó que la prescripción de Azitromicina fue inadecuada en más de 40 por ciento del total de recetas revisadas.

Drugs usage studies (DUS) in their different variants analyze the commercialization, distribution, prescription and use of the medicaments in a society in order to identify the problems in their use and their conditioning factors. It was made a DUS of the type prescription-indication with elements of consumption and therapeutic scheme where the use of available Azitromicin in four drugstores at the primary health attention area was evaluated during a period of three months in 2008. The indicated prescriptions of this antimicrobial drug were checked during the mentioned period in order to evaluate the correct administration of it taking into account the indications and the total doses ordered by Physicians. The most important results determined that the consumption of Azitromicin in this area was of two DHD (daily defined doses each 1000 inhabitants per day). The Respiratory system infections were the most frequent causes for prescribing Azitromicin but over a quarter of the prescribed doses were incorrect. It was concluded that more than a 40 percent of the evaluated prescription in the study were erroneously indicated.

Pertinencia y disponibilidad de las prescripciones de medicamentos oftálmicos en un hospital de Bogotá / Relevance and availability of ophthalmic prescription drugs at a public

Objetivos: determinar la calidad de las prescripciones de medicamentos oftálmicos en cuanto a pertinencia, grupo terapéutico, dosificación y correspondencia con el listado esencial denominado plan obligatorio de salud (POS), de acuerdo con las características del prescriptor en los serviciosde oftalmología y optometría de un hospital de Bogotá. Metodología: se realizó un estudio observacional, descriptivo, de corte transversal (prevalencia) durante los años 2007-2008, denominado“estudio de utilización de medicamentos” (EUM). Resultados: se identificó que la mayoría de medicamentos oftálmicos prescritos no pertenece al listado esencial, con mayor tendencia en su prescripción en el grupo de los oftalmólogos. La correspondencia del medicamento prescrito con la patología a resolver, denominada pertinencia en indicación-prescripción, es mayor en las prescripciones de los oftalmólogos. Los errores de prescripción detectados como “omisión en la forma farmacéutica”, “dosificación y concentración”, “medicamentos inapropiados para los diagnósticos”y “prescripción con marca comercial”, se presentan en su mayoría en las prescripciones de los optómetras. Conclusiones: existe asociación entre la edad del prescriptor, género, profesión y la calidad de los medicamentos prescritos, por lo que se explican errores de prescripción y pertenencia al listado esencial.

Objectives: To determine the quality of ophthalmic drug prescription in terms of relevance, therapeutic group, dosage and correspondence with the list of essentials, known as the Compulsory Health Plan (POS, for its initials in Spanish), according to the prescriber’s characteristics in the ophthalmology and optometry services at a hospital in Bogotá. Methodology: An observational, descriptive and cross-sectional (prevalence) study was made during 2007-2008, called the “drug utilization research” (DUR). Results: It was identified that most ophthalmic prescription drugs are not part of the POS, fitting better in the ophthalmological group. The prescribed medication’s correspondence with the pathology to be solved, which is called indication-prescription pertinence, is higher in ophthalmologist prescriptions. Prescription errors such as “omission in pharmaceutical form”, “dosage and concentration”, “inappropriate medication for diagnosis” and “brand name prescription” are more frequently found in optometrist prescriptions. Conclusions: There is a link between the age, gender and profession of the prescriber and the prescribed medication’s quality, which explains the errors in prescription and belonging in the list of essentials.

Interrelationship between the Fingerprint and Sasang Constitutional Types / 체질인류학회지

In oriental medicine, classification of the Sasang constitutional types (Tae-Yang, Tae-Eum, So-Yang, and So-Eum) is important for the treatment. To classify the Sasang constitutional types, the old methods such as pulse palpation are not objective; the recent methods such as immunohematology are expensive, painful, and time consuming. To overcome this problem, a body measurement, one of the anthropological methods, has been developed. The purpose of this study was to define whether the fingerprint, other one of the anthropological methods, is helpful to classify the Sasang constitutional types. Thus, we looked for the interrelationship between the fingerprint and Sasang constitutional types. Before analyzing the fingerprint, two kinds of questionnaires for classifying the Sasang constitutional types were surveyed on 760 Koreans (465 males, 295 females). As there was no Tae-Yang individual, we only could find the fingerprint characteristics of Tae-Eum(288 persons), So-Yang (193 persons), and So-Eum(279 persons) individuals. In the fingerprints of Tae-Eum individual, the arch types were more frequent, and the loop types were less frequent. These characteristics were prominent in female, right, second, and fifth fingers. In those of So-Yang individual, the arch types were less frequent, and the whorl types were more frequent. These characteristics were prominent in male, female, left, first, second, third, and fifth fingers. In those of So-Yang individual, fingerprint ridge count was greater in fourth finger. In those of So-Eum individual, loop types were more frequent, and whorl types were less frequent. These characteristics were prominent in male, right, left, first, third, and fifth fingers. In those of So-Eum individual, fingerprint ridge count was lesser. These characteristics were prominent in male, fourth, and fifth fingers. The fingerprint seems to be helpful to classify the Sasang constitutional types.