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Uso inapropiado de antibióticos en apendicitis aguda. Resultado de una encuesta a cirujanos mexicanos.

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Title: Uso inapropiado de antibióticos en apendicitis aguda. Resultado de una encuesta a cirujanos mexicanos.
Authors: Corona-Cruz, José Francisco1 jofran_77@hotmail.com, Melchor-Ruan, Javier1, Gracida-Mancilla, Noé Isaías1, Vega-Chavaje, Gerardo Ricardo2, Sánchez-Lozada, Raúl1
Source: Cirugía y Cirujanos. ene/feb2007, Vol. 75 Issue 1, p25-29. 5p.
Subjects: APPENDECTOMY, SURGERY, ANTIBIOTICS, SURGEONS, APPENDICITIS, ANTI-infective agents
Abstract (English): Background: Appendectomy is the most common non-elective surgery. The postoperative use of antibiotics depends on the stage of the appendix at the time of surgery. Several classifications establish that state. We determine if these classifications are known and used by Mexican surgeons. Methods: A descriptive and observational study was performed. A questionnaire was completed by surgeons asking the following questions: Do you use a classification for acute appendicitis? 2) Which classification do you prefer? 3) Do you use antibiotics postoperatively? 4) For what period of time do you administer antibiotics postoperatively? We evaluated if the postoperative treatment is influenced by the use of a classification, using the ?2 test. Results: One hundred and forty two surgeons were interviewed, 99 % used a classification, and 48 % indicated postoperative antibiotics, despite the stage of the disease, monotherapy (69 %), and for three doses (60 %). Fifty two percent used antibiotic only in advanced stages, with two different types (61 %), and from 7 to 10 days (66 %). We did not find any statistical difference in management, regardless of whether or not an appendicitis classification was used. Conclusions: Although most surgeons use one classification for acute appendicitis, this does not influence postoperative treatment. This incongruity results in the unjustified use of antibiotics. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: la apendicectomía es la cirugía no electiva más común. El uso posoperatorio de antibióticos depende del estado del apéndice al momento de la cirugía, que es determinado según diversas clasificaciones. El objetivo de este informe es identificar si en México estas clasificaciones son conocidas y usadas por los cirujanos. Material y métodos: se realizó un estudio descriptivo y observacional. Aplicamos una encuesta a cirujanos, a quienes se les preguntó si empleaban una clasificación de la apendicitis aguda; si era así, cuál preferían; si prescribían antibióticos para el posoperatorio y durante cuánto tiempo. Mediante χ² establecimos si el manejo posoperatorio está influido por una clasificación. Resultados: se encuestaron 142 cirujanos: 99 % empleaba algún tipo de clasificación y 48 % indicaba antibióticos posoperatorios, independientemente de la etapa de la enfermedad, 69 % monoterapia y 60 % por tres dosis; 52 % prescribía antibiótico sólo en etapas avanzadas, con dos tipos diferentes (61 %) y de siete a 10 días (66 %). No se encontró diferencia estadística en el tratamiento si se consideraba o no una clasificación de la apendicitis. Conclusiones: aunque la mayoría de los cirujanos utiliza algún tipo de clasificación para la apendicitis aguda, ello no influye en la decisión de manejo posoperatorio. Esta incongruencia repercute en el uso injustificado de antibióticos. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
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Abstract:Background: Appendectomy is the most common non-elective surgery. The postoperative use of antibiotics depends on the stage of the appendix at the time of surgery. Several classifications establish that state. We determine if these classifications are known and used by Mexican surgeons. Methods: A descriptive and observational study was performed. A questionnaire was completed by surgeons asking the following questions: Do you use a classification for acute appendicitis? 2) Which classification do you prefer? 3) Do you use antibiotics postoperatively? 4) For what period of time do you administer antibiotics postoperatively? We evaluated if the postoperative treatment is influenced by the use of a classification, using the ?2 test. Results: One hundred and forty two surgeons were interviewed, 99 % used a classification, and 48 % indicated postoperative antibiotics, despite the stage of the disease, monotherapy (69 %), and for three doses (60 %). Fifty two percent used antibiotic only in advanced stages, with two different types (61 %), and from 7 to 10 days (66 %). We did not find any statistical difference in management, regardless of whether or not an appendicitis classification was used. Conclusions: Although most surgeons use one classification for acute appendicitis, this does not influence postoperative treatment. This incongruity results in the unjustified use of antibiotics. [ABSTRACT FROM AUTHOR]
ISSN:00097411