Drug-related problems associated to antibiotic use in cesarean delivery: a retrospective analysis in a secondary care hospital.

Abstract

Background/Objectives A drug-related problem (DRP) is an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. The aim of this study is to identify and categorize the DRPs associated with the use of antibiotics in women undergoing cesarean delivery and to analyze the causes of these problems, making an improvement proposal of preoperative antibiotic prophylaxis (PAP) use in accordance with international guidelines. Methods Observational, retrospective, descriptive study of 814 women undergoing cesarean delivery. Prescription adequacy was assessed based on the selection, administration, dose and duration of the antibiotic therapy. DRP analysis and characterization was conducted using the Pharmaceutical Care Network Europe (PCNE) Classification V 9.1. Results DRPs were detected in all women (1125, 1.38 DRPs/patient), the most frequent ones associated to failure to administer PAP (30.10% of patients) and to unnecessary postsurgical antibiotic (100%). Of the 1935 possible causes for DRPs identified, most of them were related to inappropriate drug selection. Cefazolin was administered to 98.07% of women with PAP and 71.45% of patients received postsurgical cefalexin, with 13 different antibiotics being used in total. Conclusions The implementation of therapeutic protocols and early identification of DRPs is proposed in order to optimize antibiotic use in the institution.