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Objective The use of nutritional supplements to treat hypercholesterolemia is gradually increasing, however further studies on their efficacy and safety are required. Patients and methods The present clinical trial included patients with moderate hypercholesterolemia and cardiovascular risk who were treated either with a nutraceutical preparation containing 3.75mg of monacolin K, 515mg of berberine and 50mg of coenzyme Q10 per tablet (Lipok®) or with a placebo. The clinical and laboratory variables were analyzed at baseline and at three and six months. None of the patients was diabetic, and none was being treated with lipid-lowering drugs or with any other nutritional supplements affecting lipid metabolism. Results In patients of the intervention group and of the placebo group, baseline LDL-C was 134.7mg/dL (14.4) and 138.7mg/dL (15.2), respectively. At three months after treatment start, LDL-C had decreased by 26.1mg/dL (−32.4 to 19.7) and increased by 4.5mg/dL (−1.5 to 10.5) in the respective groups. In the intervention group, a similar decrease in non-HDL-C and total cholesterol was observed, while no significant changes were observed in either group for HDL-C, triglycerides and lipoprotein(a). A good tolerance and safety profile was observed. Conclusion In conclusion, this study demonstrates that the combination of monacolin K, berberine and coenzyme Q10 is effective and safe for treating hypercholesterolemia in patients with a moderate degree of excess LDL-C and cardiovascular risk (AU)

Objetivo El uso de suplementos nutricionales para tratar la hipercolesterolemia está aumentando de forma progresiva; sin embargo son necesarios más estudios sobre su eficacia y seguridad. Pacientes y métodos En el presente ensayo clínico fueron incluidos pacientes con hipercolesterolemia y riesgo cardiovascular moderados que fueron tratados con un preparado nutracéutico que contenía 3,75mg de monacolina K, 515mg de berberina y 50mg de coenzima Q10 por comprimido (Lipok®) o con placebo. Se analizaron las variables clínicas y de laboratorio en situación basal y a los 3 y 6 meses. Ningún paciente era diabético y ninguno seguía tratamiento con fármacos hipolipidemiantes u otros suplementos nutricionales con efectos sobre el metabolismo lipídico. Resultados En los pacientes del grupo de intervención y del grupo placebo, el c-LDL basal era de 134,7mg/dL (14,4) y 138,7mg/dL (15,2), respectivamente. A los 3 meses de tratamiento el c-LDL había disminuido 26,1mg/dL (de –32,4 a 19,7) y aumentado 4,5mg/dL (de –1,5 a 10,5) en ambos grupos, respectivamente. En el grupo de intervención se observó un descenso similar del c-no HDL y del colesterol total, mientras que no ocurrieron cambios significativos en ninguno de los 2 grupos en el c-HDL, los triglicéridos y la lipoproteína (a). Se observó un buen perfil de tolerancia y seguridad. Conclusión Este estudio demuestra que la combinación de monacolina K, berberina y coenzima Q10 es eficaz y segura para tratar la hipercolesterolemia en los pacientes con un grado de exceso de c-LDL y de riesgo cardiovascular moderados (AU)

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OBJECTIVE: The use of nutritional supplements to treat hypercholesterolemia is gradually increasing, however further studies on their efficacy and safety are required. PATIENTS AND METHODS: The present clinical trial included patients with moderate hypercholesterolemia and cardiovascular risk who were treated either with a nutraceutical preparation containing 3.75mg of monacolin K, 515mg of berberine and 50mg of coenzyme Q10 per tablet (Lipok®) or with a placebo. The clinical and laboratory variables were analyzed at baseline and at three and six months. None of the patients was diabetic, and none was being treated with lipid-lowering drugs or with any other nutritional supplements affecting lipid metabolism. RESULTS: In patients of the intervention group and of the placebo group, baseline LDL-C was 134.7mg/dL (14.4) and 138.7mg/dL (15.2), respectively. At three months after treatment start, LDL-C had decreased by 26.1mg/dL (-32.4 to 19.7) and increased by 4.5mg/dL (-1.5 to 10.5) in the respective groups. In the intervention group, a similar decrease in non-HDL-C and total cholesterol was observed, while no significant changes were observed in either group for HDL-C, triglycerides and lipoprotein(a). A good tolerance and safety profile was observed. CONCLUSION: In conclusion, this study demonstrates that the combination of monacolin K, berberine and coenzyme Q10 is effective and safe for treating hypercholesterolemia in patients with a moderate degree of excess LDL-C and cardiovascular risk.

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INTRODUCTION: The Multidimensional Weight Locus of Control Scale (MWLCS) measures a person's beliefs regarding the locus of control or lack of locus of control over his/her body weight. PURPOSE: We aim to evaluate the factorial structure and psychometric properties of the MWLCS with Spanish normal weight, overweight and obese samples. METHODS: The research was carried out in two different studies. The first included a sample of 140 normal weight participants, selected out of a 274 sample recruited with an online survey. Study 2 was carried out in a sample of 633 participants recruited from the PREDIMED-Plus study. Out of them, 558 participants fulfilled the weight criteria and were categorized into: overweight (BMI 25 - < 29.99; N = 170), obese class I (BMI 30 - < 34.99; N = 266), and obese class II (BMI 35 - < 39.99; N = 122). Exploratory (EFA) and confirmatory (CFA) factor analyses were used to evaluate the factor structure of the MWLCS, and reliabilities and Spearman's correlations were estimated. Invariance measurement was tested across the three subgroups of weight in Study 2. RESULTS: A three-factor structure indicating weight locus of control factors (internal, chance, and powerful others) was supported, both via EFA in the normal weight sample and CFA in the overweight and obese samples. In the normal weight sample, the powerful others dimension was positively related to BMI and the dimensions of the Dutch Eating Behaviors Questionnaire. Additionally, the scale showed evidence of scalar invariance across the groups with different weight conditions. CONCLUSIONS: This scale seems to be a psychometrically appropriate instrument and its use is highly recommended when designing interventions for overweight or obese individuals. LEVEL OF EVIDENCE: Level V, descriptive study.

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Objetivo: Identificar en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) prácticas diagnósticas, terapéuticas y de autocuidado que resultan inadecuadas, de dudosa efectividad o que no son coste-efectivas, tanto en fase estable como durante una agudización. Material y método: El estudio se ha organizado en 3 fases y diseñado para identificar prácticas que no aportan valor o que deben desaconsejarse en el manejo de la EPOC estable y agudizada, y en los autocuidados llevados a cabo por estos pacientes. La primera fase se realizó mediante la técnica Metaplan en la que se puntuaron y seleccionaron las prácticas que con más frecuencia claramente debían desaconsejarse. La segunda fase se hizo a través de la web mediante una técnica de conferencia de consenso que permitió la valoración y la selección jerarquizada de las recomendaciones en función de la frecuencia en que ocurren y la intensidad en el que esa práctica resultaba inútil o perjudicial. En la tercera fase se elaboró una ficha descriptiva de cada una de las recomendaciones finales, que incluye la descripción de la práctica a erradicar, el nivel de evidencia y grado de recomendación y los indicadores de la medida en que se ha logrado un cambio en la práctica. Resultados: Los resultados se mostrarán en una tabla que recogerá las prácticas ‘no hacer’ en la EPOC, con la frecuencia con que se produce la práctica que se desaconseja y la intensidad con que la práctica resulta inadecuada, tanto en la EPOC estable como en la EPOC agudizada y en las prácticas realizadas por los pacientes. Además, se desarrollará en una ficha técnica para cada recomendación en el que se expondrá la denominación, la justificación y el nivel de evidencia de la recomendación. También se elaborarán indicadores que permitan evaluar los datos recogidos y que se haya logrado cambiar la práctica inadecuada, ineficaz o no coste-efectiva. Conclusiones: Las recomendaciones 'Qué no hacer en la EPOC' mejorarán el manejo de esta patología al reducir las prácticas diagnósticas, terapéuticas o de cuidados que sean inadecuadas o no coste-efectivas

Objective: To identify diagnostic, therapeutic and self-care practices in chronic obstructive pulmonary disease (COPD) patients which are inadequate, of dubious effectiveness or non cost-effective, both in stable phase and during an exacerbation. Material and Methods: The study was performed in 3 phases and designed to identify practices which do not add value or must be discouraged in the management of stable COPD and its exacerbations, and also in self-care carried out by the patients. The first phase was carried out by the Metaplan technique in which the most frequent practices which had to be clearly discouraged were rated and selected . The second phase was made through the web by a consensus conference technique that allowed to evaluate and select hierarchically recommendations based on the frequency of occurrence and intensity of the practices which were found useless or harmful. In the third phase a technical file on each of the final recommendations was created. It includes the description of the practices which must be eradicated, evidence levels and recommendation degrees, as well as indicators of the measure achieved thanks to the change in practice. Results: The results are shown in a table that summarizes ‘do not do’ practices in COPD, the frequency with which the practice is discouraged and the intensity with which the practice is inadequate, both in stable and exacerbated COPD and in practices carried out by patients. In addition, there will be a technical file developed for each recommendation with denomination, justification and evidence level of the recommendation. Indicators, permitting to evaluate collected data and the improvements reached by decreasing inadequate, ineffective or non cost-effective practices, will also be developed. Conclusions: 'Do not do' recommendations in COPD will improve the management of this patology by reducing inadequate or non cost-effective diagnostic, therapeutic or care practices

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BACKGROUND: Erectile dysfunction affects more than 100 million men worldwide, with a wide variability in prevalence. An overall association of cardiovascular risk factors, lifestyle and diet in the context of ED in a Mediterranean population is lacking. AIM: To assess ED prevalence and associated factors in a Mediterranean cohort of non-diabetic patients with cardiovascular risk factors. METHODS: Observational, cross-sectional study of patients aged over 40 treated at cardiovascular risk units in Catalonia. Anthropometric data, risk factors, lifestyle and diet habits were recorded. ED was assessed using the International Index of Erectile Function. RESULTS: Four hundred and forty patients included, 186 (42.3%) with ED (24.8% mild, 6.8% moderate and 10.7% severe). ED presence and severity were associated with age, obesity, waist circumference, hypertension, antihypertensive treatment and ischaemic disease. Patients with ED were more frequently smokers, sedentary and consumed more alcohol. In multivariate analysis, consumption of nuts (> twice a week) (OR 0.41 (95% CI 0.25 to 0.67) and vegetables (≥ once a day) (OR 0.47 (95% CI 0.28-0,77)), were inversely related to ED. Obesity (as BMI ≥ 30 kg/m(2) ) (OR 2.49 (95% CI 1.48-4.17)), ischaemic disease (OR 2.30 (95% CI 1.22 to 4.33), alcohol consumption (alcohol-units a day) (OR 1.14 (95% CI 1.04 to 1.26), and age (year) (OR = 1.07 (95% CI 1.04-1.10) were directly related to ED. CONCLUSION: Erectile dysfunction is a common disorder in patients treated in lipid units in Catalonia for cardiovascular risk factors. This condition is associated with age, obesity, ischaemic disease and unhealthy lifestyle habits.

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BACKGROUND: Dyslipidaemia has been described in non-treated rheumatoid arthritis (RA), and improves after therapy with disease modifying anti-rheumatic drugs or glucocorticoids; however, it has generally been perceived that glucocorticoids adversely affect lipid metabolism. The association of low dose glucocorticoid therapy with plasma lipid levels was evaluated in female RA patients. MATERIALS AND METHODS: A cross-sectional study was conducted in 78 female RA patients [mean age: 60 (12) years; mean disease duration: 13 (9) years]. Sixty-five (83%) were on glucocorticoid therapy [total equivalent mean prednisone dose: 5.1 (1.7) mg d(-1)]. Each patient was assessed through a self-reported questionnaire, structured interview and physical examination. Blood samples were obtained for routine biochemistry, lipid profile and haematological tests. Lipid profiles of RA patients who were and were not on glucocorticoid therapy were compared. RESULTS: Clinical and laboratory features of the two groups of patients were similar, except for the Health Assessment Questionnaire and body mass index, which were significantly higher in the patients on glucocorticoid therapy. These patients had 14.7% higher serum high-density lipoprotein cholesterol (HDL-c) levels than untreated patients (P = 0.043), mainly at the expense of HDL2 subfraction, which was 24.4% higher (P < 0.039), whereas HDL3-c was only 7.4% higher (P = 0.219). Serum levels of glucose and total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL -c), very low-density lipoprotein cholesterol, apolipoproteins A-I and B were not increased in patients on glucocorticoid therapy. CONCLUSIONS: Low dose glucocorticoid therapy in RA patients is associated with an increase in HDL-c, without increasing LDL-c or triglyceride. These lipid changes may overall be considered favourable.

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UNLABELLED: Carotid arteriosclerosis is a marker of cardiovascular risk in the general population. Cardiovascular disease is highly prevalent in kidney transplant recipients. This study analyzed the impact of arteriosclerotic carotid lesions on the evolution of renal transplant recipients. METHODS: This prospective study was performed in 70 patients with renal transplantations (mean age 52 +/- 12 years; 67% men (n = 47). High-resolution B-mode ultrasonography (7.5 MHz) of both carotid arteries was performed at baseline to assess carotid caliber, mean and maximum intima-media thickness (IMT), presence of arteriosclerotic plaques (number and maximum height), and percentage stenosis. We analyzed the impact of carotid arteriosclerosis and various donor-recipient clinical covariables on long-term patient and graft survival. RESULTS: Mean follow-up was 9.7 +/- 2.5 years (2-14). Atheroma plaques were detected in 74% of patients (n = 52). The mean number of plaques was 3.96 +/- 2.88 and maximum plaque height was 2.49 +/- 0.97 mm. IMT was 0.71 +/- 0.21 mm (0.4-1.5) with 27% of patients (n = 19) having an IMT value greater than 0.8 mm. Sonographic signs of occlusion were evident in 13% (n = 9) and the mean occlusion was 33 +/- 11% (range 20%-45%). The presence of plaques was significantly associated with age (P = .002), hypertension and diabetes (P = .016), and hypercholesterolemia (P = .01). There was an association between age and arterial wall thickness (P = .042). Acute rejection was an independent risk factor for graft loss (OR 8.14, P = .003). The multivariate study identified carotid wall thickness as an independent risk factor for patient death (OR 12.7, P = .017). CONCLUSION: Carotid arteriosclerosis is highly prevalent among renal transplant recipients. Carotid lesions were an independent risk factor for long-term patient death. High-resolution ultrasound imaging of the carotid arteries was a useful, noninvasive diagnostic technique for accurate assessment of cardiovascular risk in renal transplant recipients.

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INTRODUCTION AND AIM: Many patients receive an antibiotic prescription at hospital emergency departments. It could be considered adequate if it is effective against an appropriate bacteria spectrum and the dosage prescribed is correct. The aim was to evaluate the antibiotic prescriptions quality at an hospital emergency department. METHOD: Retrospective study of patients attended because an infectious disease at an emergency department during a 12 days period analyzing the antibiotic prescription quality. RESULTS: One hundred eighty nine patients were included (48+/-23 years; 52% women). More frequent diseases attended were respiratory infections (58 patients 31%), urinary tract infections (33 patients, 17%) and gastroenteritis (22 patients, 12%). Most frequent prescribed antibiotic was amoxicillin with clavulanic acid (54%). In 82 cases (43%) prescription was considered incorrect. More frequent reason were having a disease that does not need antibiotics (40%), excessive dosage(27%), treatment period inappropriate prolonged (26%), short dosage(10%) and wrong antibiotic selection (5%). CONCLUSIONS: A huge proportion of patients attended at an hospital emergency department received an inadequate antibiotic treatment. Some important measures should be undertaken in order to improve the antibiotic prescription quality.

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OBJECTIVES: To estimate the cost and characterize the management of asthma attacks in primary care. DESIGN: Prospective, observational study of 1 year's duration. Setting. 10 physician's offices at 9 primary care centers located in 5 provinces (Asturias, Barcelona, Cadiz, Madrid, and Valencia) of Spain. PARTICIPANTS: 10 family physicians who saw 133 consecutive patients with an asthma attack. METHOD: Prospective, observational study; no intervention was used. Direct and indirect costs arising from asthma attacks were calculated. Episodes were treated according to the physicians' habitually used procedures; the study protocol did not specify any predetermined intervention. RESULTS: The attacks were classified as mild in 43.6% of the cases, moderately severe in 43.6%, and severe in 12.8%. Of all severe attacks, 17.2% occurred in patients with intermittent asthma. The more severe the attack, the less preventive treatment patients had received previously. The mean cost of asthma attacks was 166.7 (95% CI, 146.5-192.3); 80% (132.4) (95% CI, 122.7-143.8) were direct costs and 20% (34.3) (95% CI, 17-56.2) were indirect costs. The most economical management option was to change treatment, perform diagnostic tests and have the patient attend 2 follow-up appointments with the physician. CONCLUSIONS: Mean cost of each asthma attack treated in primary care was 166.7 (95% CI, 146.5-192.3), of which 80% were direct costs and 20% indirect costs.

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OBJECTIVES: The main objective is to assess the effect of a respiratory rehabilitation programme on the quality of life of patients with COPD. Secondary aims are to determine whether the intervention, as against the habitual monitoring, improves tolerance to exercise and pulmonary function, and reduces dyspnoea, the number of crises and hospital admissions due to COPD and the medication used to control the disease. DESIGN: Pragmatic cluster-randomised clinical trial. SETTING: Clinics of 16 PC teams in various health areas of the Community of Madrid. PARTICIPANTS: 476 patients with light-moderate COPD, who sign their informed consent. VARIABLES: Quality of life, number of crises, packages of medicines used to control the disease, unscheduled attendance, pulmonary function, dyspnoea and tolerance to exercise. METHOD: The consultations will be assigned to the control and intervention groups at random. At each clinic there will be a randomised selection from all patients with COPD and in a stable clinical condition. 238 patients are needed in each group, in order to detect a minimum difference of 4 points in quality of life, assuming a standard deviation of 16, 95% confidence level, 80% power and 20% losses. The effect between each factor and the variables evaluated through multivariate analysis will be calculated. DISCUSSION: This research project aims to show that a basic recuperative intervention, which is feasible and primary care-based, can achieve improvements in the quality of life of patients with COPD.

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Objetivos. Estimar el coste y conocer el manejo de una crisis asmática en atención primaria. Diseño. Estudio observacional, prospectivo. Emplazamiento. Diez consultas de 9 centros de atención primaria de 5 provincias (Asturias, Barcelona, Cádiz, Madrid y Valencia). Participantes. Diez médicos de familia que incluyeron, secuencialmente, a 133 pacientes con una crisis de asma. Mediciones principales. Se calcularon los costes directos e indirectos que supone una crisis de asma. El episodio se trató como habitualmente venía haciéndolo cada médico, sin que la intervención estuviera previamente definida en el protocolo del estudio. Resultados. Se observaron un 43,6% de crisis leves, un 43,6% de crisis moderadas y un 12,8% de crisis graves. El 17,2% de estas últimas ocurrieron en pacientes con asma intermitente. Cuanto más grave era la crisis, menor era el tratamiento preventivo anterior a ella. El coste medio de una crisis asmática fue de 166,7 € (intervalo de confianza [IC] del 95%, 146,5-192,3), el 80% (132,4 €; IC del 95%, 122,7-143,8) debido a costes directos y el 20% (34,3 €, (IC del 95%, 17-56,2) a costes indirectos. La opción más económica de manejo de una crisis fue «cambiar el tratamiento, realizar una prueba diagnóstica y 2 visitas médicas». Conclusiones. El coste medio de una crisis asmática tratada en atención primaria fue de 166,7 € (IC del 95%, 146,5-192,3), el 80% debido a costes directos y el 20% a costes indirectos

Objectives. To estimate the cost and characterize the management of asthma attacks in primary care. Design. Prospective, observational study of 1 year's duration. Setting. 10 physician's offices at 9 primary care centers located in 5 provinces (Asturias, Barcelona, Cadiz, Madrid, and Valencia) of Spain. Participants. 10 family physicians who saw 133 consecutive patients with an asthma attack. Method. Prospective, observational study; no intervention was used. Direct and indirect costs arising from asthma attacks were calculated. Episodes were treated according to the physicians' habitually used procedures; the study protocol did not specify any predetermined intervention. Results. The attacks were classified as mild in 43.6% of the cases, moderately severe in 43.6%, and severe in 12.8%. Of all severe attacks, 17.2% occurred in patients with intermittent asthma. The more severe the attack, the less preventive treatment patients had received previously. The mean cost of asthma attacks was €166.7 (95% CI, 146.5-192.3); 80% (€132.4) (95% CI, 122.7-143.8) were direct costs and 20% (€34.3) (95% CI, 17-56.2) were indirect costs. The most economical management option was to change treatment, perform diagnostic tests and have the patient attend 2 follow-up appointments with the physician. Conclusions. Mean cost of each asthma attack treated in primary care was €166.7 (95% CI, 146.5-192.3), of which 80% were direct costs and 20% indirect costs

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Objetivos. El objetivo principal es valorar la efectividad de un programa de rehabilitación respiratoria en la calidad de vida de pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Los objetivos secundarios son: determinar si la intervención mejora la tolerancia al ejercicio y la función pulmonar, y disminuye la sensación de disnea, el número de exacerbaciones, los ingresos hospitalarios por EPOC y el consumo de medicación necesario para el adecuado control de la enfermedad frente al seguimiento habitual. Diseño. Ensayo clínico aleatorizado por grupos pragmático. Emplazamiento. Consultas de 16 equipos de atención primaria, repartidos por diferentes áreas sanitarias de la Comunidad de Madrid. Participantes. Se incluirá en el estudio a 476 pacientes con EPOC leve-moderada, que firmarán el consentimiento informado. Variables. Calidad de vida, número de agudizaciones, envases de medicación utilizados para el control, visitas no programadas, función pulmonar, disnea y tolerancia al ejercicio. Método. Se realizará asignación aleatoria de las consultas a cada grupo, control e intervención. En cada consulta se realizará una selección aleatoria del total de pacientes con EPOC, en situación clínica estable. Se precisan 238 pacientes en cada grupo para detectar una diferencia mínima de 4 puntos en la calidad de vida, asumiendo una desviación estándar de 16, un nivel de confianza del 95%, una potencia del 80% y unas pérdidas del 20%. Se estimará el efecto entre el factor de estudio y las variables evaluadas mediante análisis multivariante. Discusión. Este proyecto de investigación pretende demostrar que una intervención rehabilitadora básica, factible e implementada en atención primaria permite alcanzar mejoras en la calidad de vida de los pacientes con EPOC

Objectives. The main objective is to assess the effect of a respiratory rehabilitation programme on the quality of life of patients with COPD. Secondary aims are to determine whether the intervention, as against the habitual monitoring, improves tolerance to exercise and pulmonary function, and reduces dyspnoea, the number of crises and hospital admissions due to COPD and the medication used to control the disease. Design. Pragmatic cluster-randomised clinical trial. Setting. Clinics of 16 PC teams in various health areas of the Community of Madrid. Participants. 476 patients with light-moderate COPD, who sign their informed consent. Variables. Quality of life, number of crises, packages of medicines used to control the disease, unscheduled attendance, pulmonary function, dyspnoea and tolerance to exercise. Method. The consultations will be assigned to the control and intervention groups at random. At each clinic there will be a randomised selection from all patients with COPD and in a stable clinical condition. 238 patients are needed in each group, in order to detect a minimum difference of 4 points in quality of life, assuming a standard deviation of 16, 95% confidence level, 80% power and 20% losses. The effect between each factor and the variables evaluated through multivariate analysis will be calculated. Discussion. This research project aims to show that a basic recuperative intervention, which is feasible and primary care-based, can achieve improvements in the quality of life of patients with COPD

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Fundamento y objetivo: Un número elevado de pacientes atendidos en los servicios de urgencia hospitalarios recibe un tratamiento antimicrobiano. Una cobertura bacteriana adecuada y posología correcta son características relevantes de la prescripción antibiótica. El objetivo fue evaluar la calidad en la prescripción antibiótica en un servicio de urgencia hospitalario. Método: Estudio retrospectivo de los pacientes atendidos en un servicio de urgencia por patología infecciosa durante 12 días examinando la calidad del tratamiento antibiótico prescrito. Resultados: Se incluyeron 189 pacientes (48 ± 23 años; 52% mujeres). Las enfermedades más frecuentes fueron infección respiratoria (58 pacientes 31%), infección del tracto urinario (33 pacientes, 17%) y gastroenteritis aguda (22 pacientes, 12%). El antibiótico prescrito con más frecuencia fue amoxicilina/clavulánico (54%). En 82 casos (43%) hubo una prescripción antibiótica incorrecta. Los motivos más frecuentes fueron ausencia de indicación de tratamiento antibiótico (40%), dosificación excesiva (27%), período de tratamiento inadecuadamente prolongado (26%), dosificación insuficiente (10%) y antibiótico distinto del apropiado (5%). Conclusiones: Una proporción muy elevada de pacientes atendidos en un servicio de urgencias recibieron un tratamiento antibiótico incorrecto. Deberían establecerse medidas para mejorar la calidad de la prescripción antibiótica

Introduction and aim: Many patients receive an antibiotic prescription at hospital emergency departments. It could be considered adequate if it is effective against an appropiate bacteria spectrum and the dosage prescripted is correct. The aim was to evaluate the antibiotic prescriptions quality at an hospital emergency department. Method: Restrospective study of patients attended because an infectious disease at an emergency department during a 12 days period analyzing the antibiotic prescrition quality. Results: One hundred eighty nine patients were included (48 ± 23 years; 52% women). More frequent diseases attended were respiratory infections (58 patients 31%), urinary tract infections (33 patients, 17%) and gastroenteritis (22 pacientes, 12%). Most frequent precribed antibiotic was amoxicillin with clavulanic acid (54%). In 82 cases (43%) prescription was considered incorrect. More frequent reason were having a disease that does not need antibiotics (40%), excesive dosage (27%), treatment period unaproppritate prologed (26%), short dosage (10%) and wrong antibiotic selection (5%). Conclusions: A huge proportion of patients attended at an hospital emergency departement received an inadequate antibiotic treatment. Some important measures should be undertaken in order to improve the antibiotic presciption quality

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