Antimicrobial prescriptions in cancer patients: An evaluation based on clinical and pharmacotherapeutic indicators

Abstract

Context: The inappropriate use of antimicrobials is a public worldwide health problem that causes increased morbidity and mortality, bacterial resistance, and care costs and hospitalizations. Aims: To evaluate the prescription of antimicrobials in patients treated at a Cuban cancer hospital, based on clinical indicators and pharmacotherapeutics. Methods: Retrospective descriptive study of prescription-indication of antimicrobials, during the period of January-December 2018, in a Cuban cancer hospital. Hospitalized patients with antimicrobial treatment were included in the study. The determination of prevalent microorganisms and bacterial resistance was analyzed through the book of infection control and antibiograms. The adequate and inadequate categories of prescriptions based on clinical and pharmacotherapeutic indicators were established to evaluate the prescription. Results: In a sample of 50 patients, laryngeal cancer (40%), surgical wound infection (48%), and beta-lactam pharmacological group (46.4%) prevailed. Eight germs were isolated, with a predominance of Pseudomonas aeruginosa (26.3%) with gentamicin resistance (66.7%). Staphylococcus spp. presented resistance to ciprofloxacin (63.6%) and amikacin (54.5%). Escherichia coli exhibited resistance to gentamicin (66.7%) and ciprofloxacin (55.6%). Appropriate prescriptions predominated (52%), with the indicator ‘indication and therapeutic scheme’ being the most difficult. Conclusions: The inappropriate use of antimicrobials constitutes a problem in cancer patients and highlights the need to implement actions that contribute to raising the quality of prescriptions to prevent microbial resistance.