Sapte greseli in folosirea antibioticelor

14 Octombrie, 2010 - 15:07

Administrarea de antibiotice in lipsa diagnosticului clinic, nefolosirea sau interpretarea gresita a datelor de laborator, utilizarea abuziva a antibioticelor in scop profilactiv, indicatiile nejustificate, alegerea gresita a antibioticelor sau a asocierilor, greseli in conducerea tratamentului si greselile din tehnica de administrare sunt cele mai frecvente sapte erori facute la folosirea antibioticelor.
Aceste erori, cuprinse intr-un studiu realizat de profesorul Mircea Angelescu, au fost prezentate si explicate cu ocazia Zilelor Stiintifice ale Institutului National de Boli Infectioase „Prof. dr. Matei Bals”, organizat in Capitala intre 13 si 16 octombrie.
Potrivit studiului, antibioticele sunt folosite, de multe ori, in orice stare febrila, fara a avea un diagnostic. De asemenea, este de evitat tratamentul la intamplare sau „pe incercate” si este gresit sa se concluzioneze pripit si nestiintific ca febra inseamna infectie. Astfel de comportamente eronate pot sa conduca la esecul tratamentului si sa creeze dificultati in stabilirea ulterioara a diagnosticului.
Studiul mai arata ca este periculoasa administrarea de antibiotice in stari febrile ce nu sunt cauzate de infectii – bolile alergice, de colagen, sistemice, neoplasme, precum si in cele infectioase cu agenti patogeni insensibili la antibiotice (viroze de cai respiratorii superioare, gripa, neuroviroze, stomatite virale, candidoze ale mucoaselor, febre eruptive virale – cand nu sunt complicate cu bacterii).
De asemenea, medicamentele antibiotice nu ar trebui folosite nici in boli bacteriene benigne, curabile spontan sau vindecabile prin masuri de igiena si dieta sau prin interventii de mica chirugie (neterocolite banale, toxiinfectii alimentare, stafilococii si streptococii cutanate) si nici in supuratii
colectate, greseala ce apare frecvent in practica chirurgicala.
Tot un grad ridicat de pericol il are su alegerea gresita a antibioticelor sau asocierea lor improprie, in lipsa unor analize specifice. In plus, medicii ar trebui sa respecte contraindicatiile specifice bolnavului tratat (sarcina, insuficienta renala, sensibilizare). In plus, un lucru important de retinut este ca antibioticele nu se administreaza profilactic.
Greseli pot sa apara si la dozarea medicatiei, la durata tratamentului (insuficienta sau prelungita inutil), sau prin schimbarea frecventa a medicatiei fara a se astepta semnele de eficacitate. Este de evitat, potrivit studiului, si continuarea tratamentului dupa aparitia reactiilor adverse, dar si abuzul de aplicari locale, pe tegumente sau mucoase sau in aerosoli.
Potrivit specialistilor Centrului European pentru Controlul si Prevenirea Bolilor (ECDC), intreaga medicina moderna este in pericol, din cauza ca agentii patogeni au devenit tot mai rezistenti la antibiotice, facand administrarea acestora inutila. Cercetatorii trag un semnal de alarma aratand ca, daca valul de rezistenta la antibiotice va continua, s-ar putea ajunge in imposibilitatea de a se mai realiza operatii de transplant, de inlocuire de articulatie a soldului, chimioterapie sau terapie intensiva pentru copiii nascuti prematur.
Pericolul vine din aparitia unor bacterii rezistente la antibiotice, asa-numitele super-bacterii. Cele sase clase mari de bacterii rezistente la antibiotice provoaca, anual, in Europa, aproape o jumatate de milion de infectii si 25.000 de victime, iar tratamentul necesita peste doua milioane si jumatate de zile de spitalizare (900 mil. euro) pe an. In Statele Unite, infectiile cu super-bacterii fac aproximativ 19.000 de victime anual.
Studiul ECDC se bazeaza pe rezultatele unui program de monitorizare la nivel european, lansat in 2002, potrivit caruia 60% dintre pacienti nu stiau ca antibioticele nu sunt eficiente impotriva virusirilor gripale sau contra racelilor jogos casino online.

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