About the Use of Antibiotics in a County Hospital
Articol din publicatia Timisoara Medical Journal nr. 2/2005
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A Romanian Perspective (I)
Cristina Brinzeu (1), Leonard Mada (2), Andrei Brinzeu (2), Antoniu Brinzeu (2)
1 Department of Anesthesiology and Intensive Care, County Hospital, Timisoara
2 "Victor Babes" University of Medicine and Pharmacy, Timisoara
Antoniu Branzeu, MD, Odobescu 39, Timisoara, Romania
Antibiotherapy has a great impact on morbidity and mortality. At the same time it accounts for a significant proportion of hospital costs. An antibiotic policy becomes necessary to ensure adequate treatment while minimizing the development of bacterial resistance and keeping treatment costs at an affordable level.
There are various means to implement and endorse a successful antibiotic policy. Proven methods include the continuous education of the personnel, regular presentations of new study results, consensus conferences, guidelines and treatment protocols. This review, divided into several parts, starts by presenting the antibioprophylaxis in surgery, explaining the reasons and the currently recommended regimens. We shift then the focus to intra-abdominal infections describing the various disease entities and classification schemes needed to better understand the treatment strategies. Antibiotic regimens will be presented in the light of current evidence and increasing resistance trends, followed by recommendations for antibiotic use in the local county hospital. Necrotizing pancreatitis is presented separately because of the high risk of infectious complications, which portend an unfavorable outcome. The evidence supporting antibioprophylaxis and therapy of infected pancreatic necrosis is presented thereafter. The remaining infections, including but not limited to pulmonary and urinary tract infections will be presented in a subsequent article.