Abstract
ABSTRACTOBJECTIVE To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials.METHODS A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II).RESULTS The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006–0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003–0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05).CONCLUSIONS The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.
Highlights
Bacterial resistance to antimicrobials (ATM) poses a serious threat to global public health
The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism
Study Design, Location and Population. This is a historical cohort study including adult patients admitted to the Hospital Risoleta Tolentino Neves (HRTN) in the period from May 2010 to July 2011
Summary
Bacterial resistance to antimicrobials (ATM) poses a serious threat to global public health. Resistance can decrease the effectiveness of ATM, requiring the administration of second line drugs, which are usually more toxic and costly, causing damage to the patient and increasing the hospitalization time and expenses for the individual and for the health system[5,6]. Specific characteristics of developing countries favor the occurrence of microbial resistance in these places, such as low hygiene conditions, poor living conditions, poor quality of medications and access to the parallel market of ATM7. An increase in the consumption of ATM in emerging countries is identified, with Brazil being among the five countries with the highest indices between 2000 and 20108. Studies on microbial resistance published in the country so far present incipient data[9], but show expressive increase in the resistance of these organisms and, increased morbidity and mortality and the cost of infections[10,11]
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