Guía Terapéutica Antibiótica 4.7

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Antimicrobials are a very large group of extraordinarily effective and complex drugs. Since their discovery 70 years ago, they have saved millions of lives and enabled medical advances, becoming essential medicines for the treatment of most bacterial infections.

The development of resistance to antimicrobials, the appearance and spread of multi-resistant bacteria and the scarcity of alternative treatments are one of the biggest public health problems today. Although there are many factors that favor the selection and spread of resistance to antibiotics, their inappropriate and indiscriminate use is one of the main factors that contribute to this phenomenon.

The use of antimicrobials in the hospital environment can be improved in 30-50% of cases. The existence of resistant microorganisms and their variability between hospitals and even within different areas of the same hospital requires a good knowledge of local microbiological epidemiology. The optimal selection of the antimicrobial and its dosage in the different infectious syndromes also require specific and up-to-date training.

With the aim of promoting a more adequate use of antimicrobials, the Hospital Infection Commission of the Hospital Son Espases (Palma de Mallorca, Spain) has updated the protocols for action in infectious diseases with this third edition.

With the app format of the protocols manual, we want to facilitate the dissemination and use of these protocols, and make them accessible and easy to read so that they are useful in daily clinical practice. Full protocols with their bibliography can also be accessed from the home page for further study.

The application is intended for doctors and pharmacists in general, and includes both general aspects of the use of antimicrobials (prevention of the appearance of resistance, dosage in renal and hepatic failure, dosage in obese patients, pharmacokinetics and pharmacodynamics, etc.), as well as guidelines. specific treatment by apparatus (respiratory, digestive, urinary, etc). It must be taken into account that these are local recommendations based on the specific situations of our center and on the information on antibiotic susceptibility provided by the Microbiology Service of the Hospital Son Espases, so some of the recommendations must be interpreted and adapted to the location of the reader.

We have also wanted to facilitate access to other resources such as clinical calculators, courses and clinical cases. This is the description of all the functionalities of the application:

- Off-line reading of the general aspects of the use of antimicrobials, treatment protocols, and prophylaxis protocols.
- Off-line reading and downloading of the complete protocols with their bibliographical references (PDF format).
- Clinical calculators: BMI, obese dose, renal function, CPIS scale, CURB-65 scale, Fine scale (PSI), Child-Pugh scale, Barthel index and Pfeiffer test.
- Courses: link to the Infectious Diseases courses taught in recent years.
- Clinical cases: every 15 days a clinical case is presented and a questionnaire is launched on it. After a few days the case is resolved and discussed.
- Suggestion box: send your comments, corrections or suggestions to improve the application.

The authors.