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Biomedical subjects

L Guerra Romero

Publications and source records attributed to L Guerra Romero.

9 recordsLinked to original sources
PubMed1999

[Antibiotic prescription in acute respiratory infections in adults: its variability and appropriateness in 10 Spanish hospitals].

OBJECTIVE: To report the variability in antibiotic prescribing habits for patients diagnosed of non-specified acute respiratory infections (ARI) (according to the International Classification of Diseases 9MC) at Emergency Departments of ten Spanish hospitals, and to evaluate the appropriateness of antimicrobial prescription for such patients, after specifically elaborating some reference patterns for appropriate antimicrobial use. DESIGN: Descriptive study of variability in clinical practice by means of a prospective series of cases. Study of appropriateness by means of elaborating reference standards for appropriate use and comparison with the data from the descriptive study with such standards. DURATION: six months. SETTING: Emergency Department in ten Spanish hospitals from different autonomic communities: Andalucía, Islas Canarias, Castilla-León, Cataluña, Galicia, Madrid, Murcia and Valencia for a 6-month period. PATIENTS: Patients with the diagnosis of community ARI attended at emergency departments. SAMPLE SIZE: 903 cases. INTERVENTIONS: Collection of cases in a unified database with the following variables: age, sex, ARI type, diagnosis of comorbidity, prescribed antimicrobial, hospital admission and type of prescriber. A panel of experts was commissioned to elaborate the gold standards for the appropriate use of antibiotics or the lack of indication for the different locations of ARI. RESULTS: The adjusted proportion of the inappropriate prescription for the group with laryngo-tracheal-influenza-rhinopharyngitis-multiple ARI or non specified infections was 67.9%. CONCLUSIONS: Concerning antibiotic prescription, significant inter-center variability and relevant heterogeneity were observed.

Acute Disease↗
PubMed1999

[The natural history of of the antiretrovirals: the continuum of their evaluation].

Antiretroviral drugs have, as any medical therapy, their natural history. They are born by screening or designing of molecules with activity against HIV, their efficacy and safety is investigated by clinical trials, evaluated by regulatory bodies, used by clinical practice, and finally analyzed by quality of care, economic, social and ethical studies. This flow of information is dynamically accumulated, but it may stop if negative results are obtained. The described knowledge pathway implies that specific methods are needed to answer different questions. At the same time, many decisions have to be taken in order to keep the process flowing, including multiple agents, such as drug industries, government departments, clinicians, health care providers and health policy makers. This paper describes a comprehensive conceptual framework, including the "knowledge" on antiretroviral drugs, the "methodologies" needed to generate them, and the underlying processes of "decision making". It proposes the need for a continuum of assessment of these drugs.

Anti-HIV Agents↗