Background: Preoperative antibiotic prophylaxis is essential for preventing surgical site infection (SSI). The aim of this study was to evaluate compliance with international and local recommendations in caesarean deliveries carried out at the Obstetrics and Gynaecology Service of the Ambato General Hospital, as well as any related health and economic consequences. Methods: A retrospective indication-prescription drug utilization study was conducted using data from caesarean deliveries occurred in 2018. A clinical pharmacist assessed guidelines compliance based on the following criteria: administration of antibiotic prophylaxis, antibiotic selection, dose, time of administration and duration. The relationship between the frequency of SSI and other variables, including guideline compliance, was analysed. The cost associated with the antibiotic used was compared with the theoretical cost considering total compliance with recommendations. Descriptive statistics, Odds Ratio and Pearson Chi Square were used for data analysis by IBM SPSS Statistics version 25. Results: The study included 814 patients with an average age of 30.87 ± 5.50 years old. Among the caesarean sections, 68.67% were emergency interventions; 3.44% lasted longer than four hours and in 0.25% of the deliveries blood loss was greater than 1.5 L. Only 69.90% of patients received preoperative antibiotic prophylaxis; however, 100% received postoperative antibiotic treatment despite disagreement with guideline recommendations (duration: 6.75 ± 1.39 days). The use of antibiotic prophylaxis was more frequent in scheduled than in emergency caesarean sections (OR = 2.79, P = 0.000). Nevertheless, the timing of administration, antibiotic selection and dose were more closely adhered to guideline recommendations. The incidence of surgical site infection was 1.35%, but tended to increase in patients who had not received preoperative antibiotic prophylaxis (OR = 1.33, P = 0.649). Also, a significant relationship was found between SSI and patient age (χ² = 8.08, P = 0.036). The mean expenditure on antibiotics per patient was 5.7 times greater than that the cost derived from compliance with international recommendations. Conclusions: Surgical antibiotic prophylaxis compliance was far below guideline recommendations, especially with respect to implementation and duration. This not only poses a risk to patients but leads to unnecessary expenditure on medicines. Therefore, this justifies the need for educational interventions and the implementation of institutional protocols involving pharmacists.

Para lograr una atención médica de calidad, resulta insuficiente realizar el diagnóstico y elegir la terapéutica adecuada. Es cierto que son los primeros aspectos a tomar en cuenta para la cura, alivio y profilaxis de una enfermedad, pero si luego, no se administra el medicamento de la manera adecuada, todo el camino recorrido se vería afectado. El profesional de enfermería juega un importante papel, si toma en consideración aspectos farmacológicos que se encuentran estrechamente vinculados. El presente artículo tuvo como objetivo realizar una puesta al día de los aspectos más relevantes a tener en cuenta por parte de los enfermeros para garantizar la calidad de vida del paciente. La seguridad del medicamento no puede ser un proyecto a largo plazo, ha de ser un desafío constante de cada uno de los profesionales que toca con sus manos el medicamento con el objetivo de mejorar la salud de los pacientes.

Introducción: La desnutrición es un problema de salud en el mundo, y la Sierra ecuatoriana es una región bastante afectada por dicha situación. En esta investigación, se evaluó el estado nutricional de la población adulta no hospitalizada de un cantón de dicha zona. Materiales y métodos: se realizó un estudio observacional, descriptivo, de corte transversal en una muestra de 115 pacientes adultos del cantón Cevallos, en la región Sierra del Ecuador durante el periodo de abril a septiembre del 2016. Para determinar el estado nutricional, se utilizó el cálculo del índice de masa corporal. Las enfermedades asociadas se determinaron a partir de la anamnesis de cada uno de los pacientes. Todos los resultados fueron evaluados mediante la determinación de valores porcentuales y se utilizó el coeficiente de correlación de Pearson para determinar la relación entre estado nutricional y enfermedades asociadas. Resultados: el 82.61 % de los pacientes estaban desnutridos. El 69.56 % presentaba enfermedades asociadas a un predominio de hipertensión arterial (41.84 %), diabetes mellitus (21.44 %) y cardiopatía isquémica (18.37 %). La correlación desnutrición-enfermedades asociadas fue prácticamente nula. Conclusiones: conocer el estado de salud de la población de los adultos pertenecientes al cantón Cevallos, permitió crear los espacios necesarios para garantizar atención médica en el desarrollo de las actividades de la población, así como diseñar un programa de charlas educativas para los beneficiarios.

Background Preoperative antibiotic prophylaxis is essential for preventing surgical site infection (SSI). The aim of this study was to evaluate compliance with international and local recommendations in caesarean deliveries carried out at the Obstetrics and Gynaecology Service of the Ambato General Hospital, as well as any related health and economic consequences. Methods A retrospective indication-prescription drug utilization study was conducted using data from caesarean deliveries occurred in 2018. A clinical pharmacist assessed guidelines compliance based on the following criteria: administration of antibiotic prophylaxis, antibiotic selection, dose, time of administration and duration. The relationship between the frequency of SSI and other variables, including guideline compliance, was analysed. The cost associated with the antibiotic used was compared with the theoretical cost considering total compliance with recommendations. Descriptive statistics, Odds Ratio and Pearson Chi Square were used for data analysis by IBM SPSS Statistics version 25. Results The study included 814 patients with an average age of 30.87 ± 5.50 years old. Among the caesarean sections, 68.67% were emergency interventions; 3.44% lasted longer than four hours and in 0.25% of the deliveries blood loss was greater than 1.5 L. Only 69.90% of patients received preoperative antibiotic prophylaxis; however, 100% received postoperative antibiotic treatment despite disagreement with guideline recommendations (duration: 6.75 ± 1.39 days). The use of antibiotic prophylaxis was more frequent in scheduled than in emergency caesarean sections (OR=2.79, P=0.000). Nevertheless, the timing of administration, antibiotic selection and dose were more closely adhered to guideline recommendations. The incidence of surgical site infection was 1.35%, but tended to increase in patients who had not received preoperative antibiotic prophylaxis (OR=1.33, P=0.649). Also, a significant relationship was found between SSI and patient age (Chisq=8.08, P=0.036). The mean expenditure on antibiotics per patient was 5.7 times greater than that the cost derived from compliance with international recommendations. Conclusions Surgical antibiotic prophylaxis compliance was far below guideline recommendations, especially with respect to implementation and duration. This not only poses a risk to patients but leads to unnecessary expenditure on medicines. Therefore, this justifies the need for educational interventions and the implementation of institutional protocols involving pharmacists.

Background/Objectives A drug-related problem (DRP) is an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. The aim of this study is to identify and categorize the DRPs associated with the use of antibiotics in women undergoing cesarean delivery and to analyze the causes of these problems, making an improvement proposal of preoperative antibiotic prophylaxis (PAP) use in accordance with international guidelines. Methods Observational, retrospective, descriptive study of 814 women undergoing cesarean delivery. Prescription adequacy was assessed based on the selection, administration, dose and duration of the antibiotic therapy. DRP analysis and characterization was conducted using the Pharmaceutical Care Network Europe (PCNE) Classification V 9.1. Results DRPs were detected in all women (1125, 1.38 DRPs/patient), the most frequent ones associated to failure to administer PAP (30.10% of patients) and to unnecessary postsurgical antibiotic (100%). Of the 1935 possible causes for DRPs identified, most of them were related to inappropriate drug selection. Cefazolin was administered to 98.07% of women with PAP and 71.45% of patients received postsurgical cefalexin, with 13 different antibiotics being used in total. Conclusions The implementation of therapeutic protocols and early identification of DRPs is proposed in order to optimize antibiotic use in the institution.