Uso de una prueba rápida de rotavirus en la prescripción de antibióticos en diarrea aguda pediátrica: un estudio observacional, aleatorizado y controlado / Use of rotavirus rapid test in the prescription of antibiotics in acute pediatric diarrhea: an observational study, randomized controlled
Rev. gastroenterol. Perú
; 32(1): 11-15, ene.-mar. 2012. tab
Article
in Spanish
| LILACS, LIPECS
| ID: lil-646586
Responsible library:
PE1.1
RESUMEN
OBJETIVO:
Evaluar el efecto de la disponibilidad de un método diagnóstico rápido y preciso de rotavirus sobre la frecuencia en el uso de antibióticos en niños menores de 5 años con diarrea aguda de menos de 5 días de duración del Hospital Nacional Arzobispo Loayza; Lima, Perú. MATERIALES YMÉTODOS:
se realizó un estudio observacional, prospectivo, aleatorizado, controlado, entre Julio 2008 y Enero 2009. Se asignó aleatoriamente 101 pacientes al Grupo A (con prueba de leucocitos fecales) y 100 al Grupo B (con prueba de leucocitos fecales y prueba rápida de rotavirus/adenovirus). Se evaluó en cada grupo la decisión clínica de administrar o no antibióticos.RESULTADOS:
No existieron diferencias significativas en el tiempo de enfermedad, edad ni peso entre ambos grupos. Los casos de rotavirus tuvieron leucocitos fecales positivos en un 46.9%. El grado de positividad de los leucocitos fecales se asoció de manera directamente proporcional al uso de antibióticos (P<0.0001). El grupo positivo a rotavirus presentó un mayor riesgo de hospitalización que el grupo negativo a este agente (21.9% vs. 6.3%, P<0.0001). No se registraron muertes atribuibles a diarrea.CONCLUSIONES:
La disponibilidad de un diagnóstico rápido y preciso de rotavirus en menores de 5 años con diarrea aguda, redujo significativamente el uso de antibióticos.ABSTRACT
OBJECTIVE:
To determine the impact of a rapid and accurate rotavirus test in the emergency ward on the reduction of antibiotic prescription in children under 5 years old with acute diarrhea at ôArzobispo Loayza National Hospitalõ, Lima, Peru. MATERIAL ANDMETHODS:
We performed an observational prospective randomized controlled study, from July 2008 to January 2009. Stool samples from patients with diarrhea lasting less than 5 days were analyzed. Out of 201 cases, 101 were classified in Group A (with fecal leukocytes test performed) and 100 in Group B (with fecal leukocytes test and rotavirus/adenovirus test performed). We aimed to associate the signs and symptoms with the decision of prescribing antibiotics and with hospitalization risk.RESULTS:
Both groups were comparable with regard to age, weight and illness duration. In patients with rotavirus infection, fecal leukocytes were positive in 46.9% of cases. Frequency of antibiotic use was directly associated with the number of fecal leukocytes (P<0.0001). There was a higher risk of admission in the group positive to rotavirus than in the group negative to this agent (21.9% vs. 6.3, P<0.0001). No diarrhea-attributable deaths were reported.CONCLUSION:
The use of rotavirus test in the pediatric emergency room decreased antibiotic prescription in children with diarrhea.
Full text:
Available
Collection:
National databases
/
Peru
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
/
Neglected Diseases
/
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Goal 10: Communicable diseases
/
Target 3.3: End transmission of communicable diseases
/
Target 3.2: Reduce avoidable death in newborns and children under 5
/
Diarrhea
/
Neglected Diseases
/
Diarrhoeal Infections
/
Infections
Database:
LILACS
/
LIPECS
Main subject:
Rotavirus Infections
/
Adenoviridae Infections
/
Rotavirus
/
Diarrhea, Infantile
/
Anti-Bacterial Agents
Type of study:
Controlled clinical trial
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Infant, Newborn
Language:
Spanish
Journal:
Rev. gastroenterol. Perú
Year:
2012
Document type:
Article
Institution/Affiliation country:
Hospital Nacional Arzobispo Loayza/PE
/
Universidad Peruana Cayetano Heredia/PE