{"id":10310,"date":"2021-06-30T11:20:36","date_gmt":"2021-06-30T09:20:36","guid":{"rendered":"https:\/\/eoc.cat\/antibioticoterapia-profilactica\/"},"modified":"2025-01-28T10:40:19","modified_gmt":"2025-01-28T09:40:19","slug":"antibioticoterapia-profilactica","status":"publish","type":"post","link":"https:\/\/eoc.cat\/ca\/antibioticoterapia-profilactica\/","title":{"rendered":"En qu\u00e8 consisteix l\u2019antibioticoter\u00e0pia profil\u00e0ctica abans d’una cirurgia?"},"content":{"rendered":"

En aquest article et parlem de antibioticoter\u00e0pia profil\u00e0ctica<\/strong>, un tema fonamental del temari del nostre Curs d’Auxiliar de Quir\u00f2fan i central d’esterilitzaci\u00f3 d’equips<\/a>.<\/p>\n

Actualment, \u00e9s ben coneguda l’efic\u00e0cia dels antibi\u00f2tics que s’utilitzen de manera preventiva abans de qualsevol mena de cirurgia<\/strong>. El prop\u00f2sit d’aquest article \u00e9s explicar l’\u00fas adequat, segur i efica\u00e7 dels antibi\u00f2tics en la prevenci\u00f3 prim\u00e0ria postoperat\u00f2ria<\/strong>, especialment en la fase preoperat\u00f2ria. Entrem detalladament.<\/p>\n

Qu\u00e8 \u00e9s la profilaxi?<\/h2>\n

En primer lloc, definim el concepte. Del grec prophylaxis<\/em>, en medicina \u00e9s tota aquella acci\u00f3 preventiva que tracta d’impedir l’aparici\u00f3 de malalties infectocontagioses<\/strong>. En cas de produir-se, la profilaxi intenta contrarestar la propagaci\u00f3 de la malaltia.<\/p>\n

Una de les mesures profil\u00e0ctiques m\u00e9s habituals a nivell hospitalari consisteix a a\u00efllar al malalt davant la sospita de malaltia infectocontagiosa. Per aquest motiu, s’a\u00eflla a la seva habitaci\u00f3 i els seus utensilis no surten d’aquesta fins a la seva desinfecci\u00f3 despr\u00e9s de l’alta, en cas de confirmaci\u00f3 microbiol\u00f2gica. Sens dubte, es tracta de la millor profilaxi<\/strong> per a tots el que estiguin al seu voltant.<\/p>\n

No obstant aix\u00f2, tots estem vivint avui dia una situaci\u00f3 complexa derivada de la pand\u00e8mia. En aquest sentit, un altre bon exemple de profilaxi \u00e9s l’\u00fas de m\u00e0scares, gels hidroalcoh\u00f2lics desinfectants i, per descomptat, les vacunes. Les vacunes han demostrat la seva capacitat per a poder disminuir el risc d’infecci\u00f3 i de generar immunitat enfront del virus SARS-CoV-2, reduint el risc d’hospitalitzaci\u00f3 i mort en percentatges superiors al 97%.<\/p>\n

Els preservatius, tamb\u00e9 anomenats profil\u00e0ctics, s\u00f3n un altre exemple de model de prevenci\u00f3 enfront de possibles infeccions, en aquest cas de transmissi\u00f3 sexual.<\/p>\n

Qu\u00e8 \u00e9s i en qu\u00e8 consisteix la antibioticoter\u00e0pia profil\u00e0ctica abans de la cirurgia?<\/h2>\n

Les infeccions en lloc quir\u00fargic (ferida quir\u00fargica)<\/strong> posen en risc als pacients. De fet, \u00e9s una de les complicacions freq\u00fcents associades, aix\u00ed com les infeccions associades a sondatges o intubaci\u00f3. Actualment, representen fins i tot un desafiament per a la pr\u00e0ctica m\u00e8dica.<\/p>\n

L’objectiu de la profilaxi preoperat\u00f2ria amb antibi\u00f2tics<\/strong> \u00e9s disminuir la incid\u00e8ncia d’infeccions i, amb aix\u00f2, la morbiditat o seq\u00fceles.<\/p>\n

Segons recull un prestigi\u00f3s estudi dirigit pel Dr. Guti\u00e9rrez, la profilaxi antibi\u00f2tica \u00e9s el complement excels per a la pr\u00e0ctica d’una bona t\u00e8cnica quir\u00fargica. Tingues en compte que representa aproximadament el 30% de l’aplicaci\u00f3 d’antibi\u00f2tics entre els pacients que estan hospitalitzats.<\/p>\n

Malgrat tot, no oblidis que una profilaxi inadequada<\/strong> t\u00e9 potencials efectes adversos. A nivell poblacional, augmenta el risc de resist\u00e8ncia bacteriana i a nivell individual pot haver-hi reaccions adverses a medicaments o alteraci\u00f3 de la flora habitual, sense que sigui degut a mala praxi.<\/p>\n

\"antibioticoter\u00e0pia\"<\/p>\n

L’elecci\u00f3 dels antibi\u00f2tics<\/h2>\n

En l’actualitat, el protocol habitual preoperatori de antibioticoter\u00e0pia profil\u00e0ctica<\/strong> estableix una s\u00e8rie de variables d’\u00fas com\u00fa en la prevenci\u00f3 d’infeccions. La m\u00e9s efica\u00e7 \u00e9s triar els antibi\u00f2tics adequats i, per a aix\u00f2, es tenen en compte aquests aspectes:<\/p>\n

    \n
  • L’acci\u00f3 antimicrobiana ha de ser especialment activa i actuar enfront dels microorganismes<\/strong> que amb major probabilitat puguin contaminar l’entorn quir\u00fargic. No fa falta cobrir tota la flora bacteriana existent, per\u00f2 s\u00ed que cal valorar les caracter\u00edstiques i circumst\u00e0ncies que siguin particulars en cada hospital. A m\u00e9s, \u00e9s important con\u00e8ixer l’estad\u00edstica de prevalen\u00e7a local a resist\u00e8ncies antibi\u00f2tiques.<\/li>\n
  • Els antibi\u00f2tics han de ser administrats en les dosis i per\u00edodes adequats perqu\u00e8 aconsegueixin les concentracions tissulars \u00f2ptimes durant el per\u00edode de potencial contaminaci\u00f3.<\/li>\n
  • Per a intentar reduir al m\u00e0xim els microorganismes resistents, la prevenci\u00f3 mitjan\u00e7ant antibioticoter\u00e0pia ha de tenir el menor espectre antimicrobi\u00e0 possible<\/strong>. A m\u00e9s, no pot ser t\u00f2xic, ha de proporcionar una vida mitjana\/llarga i, a poder ser, administrar-se amb rapidesa. Sent aix\u00ed, es distorsiona lleument la microbiota del pacient, es minimitzen els efectes secundaris i s’abarateixen els costos.<\/li>\n
  • Han de tenir-se en compte les caracter\u00edstiques del pacient i el risc, perqu\u00e8 no tota cirurgia implica l’\u00fas d’antibi\u00f2tics.<\/li>\n<\/ul>\n

    Quir\u00f2fans as\u00e8ptics<\/h2>\n

    Aquesta profilaxi \u00e9s un complement, per la qual cosa el seu \u00fas no implica seguir les regles d’as\u00e8psia i antis\u00e8psia imprescindibles per a qualsevol intervenci\u00f3.<\/p>\n

    Com a conclusi\u00f3, la antibioticoter\u00e0pia profil\u00e0ctica<\/strong> \u00e9s el millor m\u00e8tode preoperatori per a prevenir s\u00e8psia, complicacions infeccioses locals o sist\u00e8miques i, a m\u00e9s, redueix el risc de resist\u00e8ncia bacteriana i l’aparici\u00f3 d’infeccions creuades.<\/p>\n","protected":false},"excerpt":{"rendered":"

    En aquest article et parlem de antibioticoter\u00e0pia profil\u00e0ctica, un tema fonamental del temari del nostre Curs d’Auxiliar de Quir\u00f2fan i central d’esterilitzaci\u00f3 d’equips. Actualment, \u00e9s ben coneguda l’efic\u00e0cia dels antibi\u00f2tics que s’utilitzen de manera preventiva abans de qualsevol mena de cirurgia. El prop\u00f2sit d’aquest article \u00e9s explicar l’\u00fas adequat, segur i efica\u00e7 dels antibi\u00f2tics en […]<\/p>\n","protected":false},"author":7,"featured_media":9163,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[88,91],"tags":[89,92,102],"class_list":["post-10310","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-auxiliar-infermeria","category-auxiliar-quirofan","tag-auxiliar-infermeria","tag-auxiliar-quirofan","tag-emergencies-sanitaries"],"yoast_head":"\nL\u2019antibioticoter\u00e0pia profil\u00e0ctica abans d'una cirurgia | EOC<\/title>\n<meta name=\"description\" content=\"En aquest article et parlem de antibioticoter\u00e0pia profil\u00e0ctica, un tema fonamental del temari del nostre Curs d'Auxiliar de Quir\u00f2fan.\" \/>\n<meta name=\"robots\" content=\"index, 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