Profile of the prescription of antibioticoprophylaxis in Manaus public hospital

The rational use of prophylactic antibiotics (PA) through the follow-up of protocols is imperative to avoid infections in surgical sites, damage to the patient, associated costs, and microbial resistance. This study aimed to analyze the use of PA at the Getúlio Vargas University Hospital (HUGV) in 2017. Patient data, used in the Microsoft Excel® 2010 spreadsheet, from the HUGV Pharmacy Service, who used AP in 2017 were used. Univariate statistical analyzes of frequency distribution, calculation of central tendency, and dispersion were performed with the statistical program R version 3.1.2. The variables used were: date of attendance, clinic, bed, prescribed medication, concentration, dosage, indication, and time of use, according to the Standard Operating Procedure (POP) of HUGV Surgical The rational use of prophylactic antibiotics (PA) through the follow-up of protocols is imperative to avoid infections in surgical sites, damage to the patient, associated costs and microbial resistance. This study aimed to analyze the use of PA at the Getúlio Vargas University Hospital (HUGV) in 2017. Patient data, used in the Microsoft Excel® 2010 spreadsheet, from the HUGV Pharmacy Service, who used AP in 2017 were used. Univariate statistical analyzes of frequency distribution, calculation of central tendency, and dispersion were performed with the statistical program R version 3.1.2. The variables used were: date of attendance, clinic, bed, prescribed medication, concentration, dosage, indication, and time of use, according to the Standard Operating Procedure (POP) of HUGV Surgical Antibiotic Prophylaxis. Altogether 82.2% of the 2759 AP requests were in accordance with the POP. The surgical clinic was the source of most prescriptions (81.2%), of which 16.7% were inadequate. Cefazolin was the most requested medication (78%) followed by ceftriaxone and metronidazole, which had conformities in their prescriptions of 94.2%, 0%, and 75.6%, respectively. The main reasons for non-compliance were the use of non-standard antibiotics (49.07%) and use for more than 24 hours (36.72%). Regardless of the high adherence to the institution's Antibiotic Prophylaxis POP in 2017, it was observed that the cost of nonconformities (R$ 15,474.11), corresponding to 490 prescriptions, would be higher than the amount spent on prescriptions in conformity (R $ 14,822.95) in 2269 prescriptions.O uso racional de antibióticos profiláticos (AP) através do seguimento de protocolos é imperativo para evitar infecções em sítios cirúrgicos, danos ao paciente, custos associados e resistência microbiana. Este estudo teve como objetivo analisar o uso de AP no Hospital Universitário Getúlio Vargas (HUGV) no ano de 2017. Foram utilizados os dados de pacientes, constantes na planilha do Microsoft Excel® 2010, do Serviço de Farmácia do HUGV que usaram AP em 2017. Análises estatísticas univariadas de distribuição da frequência, cálculo de tendência central e de dispersão foram feitas com o programa estatístico R versão 3.1.2. As variáveis estudadas foram: data de atendimento, clínica, leito, medicamento prescrito, concentração, posologia, indicação e tempo de uso, conforme o Procedimento Operacional Padrão (POP) de Antibioticoprofilaxia Cirúrgica do HUGV. Ao todo 82,2% das 2759 solicitações de AP estiveram conformes com o POP. Sendo a clínica cirúrgica a origem da maioria das prescrições (81,2%) das quais 16,7% estavam inadequadas. Cefazolina foi o medicamento mais solicitado (78%) seguido de ceftriaxona e metronidazol que possuíram conformidades em suas prescrições de 94,2%, 0% e 75,6%, respectivamente. Os principais motivos de não conformidades foram o uso de antibióticos não padronizados (49,07%) e uso por tempo superior a 24 horas (36,72%). Observou-se que, embora tenha ocorrido elevada adesão ao POP de Antibioticoprofilaxia da instituição no ano de 2017, o custo de não conformidades (R$15.474,11), correspondente às 490 prescrições, seria superior ao valor gasto com prescrições em conformidade (R$14.822,95) em 2269 prescrições.1Nã