title: The cost of excessive postoperative use of antimicrobials: the context of a public hospital.
abstract: OBJECTIVE
  To evaluate the improper use of antimicrobials during the postoperative period and its economic impact.
  
  
  METHODS
  We conducted a prospective cohort study by collecting data from medical records of 237 patients operated on between 01/11/08 and 31/12/08.
  
  
  RESULTS
  from the 237 patients with the information collected, 217 (91.56%) received antimicrobials. During the postoperative period, 125 (57.7%) patients received more than two antimicrobials. On average, 1.7 ± 0.6 antimicrobials were prescribed to patients, the most commonly prescribed antibiotic being cephalothin, in 41.5% (154) of cases. The direct cost of antimicrobial therapy accounted for 63.78% of all drug therapy, this large percentage being attributed in part to the extended antimicrobial prophylaxis. In the case of clean operations, where there was a mean duration of 5.2 days of antibiotics, antimicrobials represented 44.3% of the total therapy cost.
  
  
  CONCLUSIONS
  The data illustrate the impact of overuse of antimicrobials, with questionable indications, creating situations that compromise patient safety and increasing costs in the assessed hospital.
authors.affiliation: Universidade de Brasilia.
authors.forename: Rafael Santos
authors.initials: RS
authors.lastname: Santana
authors.affiliation: Departamento de Assistência Farmacêutica, Secretaria de Ciência e Tecnologia e Insumos Estratégicos, MS, Brazil.
authors.forename: Ariane de Carvalho
authors.initials: Ade C
authors.lastname: Viana
authors.affiliation: Departamento de Assistência Farmacêutica, Secretaria de Ciência e Tecnologia e Insumos Estratégicos, MS, Brazil.
authors.forename: Jozimário da Silva
authors.initials: Jda S
authors.lastname: Santiago
authors.affiliation: Departamento de Assistência Farmacêutica, Secretaria de Ciência e Tecnologia e Insumos Estratégicos, MS, Brazil.
authors.forename: Michelle Santos
authors.initials: MS
authors.lastname: Menezes
authors.affiliation: Hospital Universitário, Universidade Federal de Sergipe.
authors.forename: Iza Maria Fraga
authors.initials: IM
authors.lastname: Lobo
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro.
authors.forename: Paulo Sergio
authors.initials: PS
authors.lastname: Marcellini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006779:Hospitals, Public; D006801:Humans; D057970:Inappropriate Prescribing / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents