<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0121-0793</journal-id>
<journal-title><![CDATA[Iatreia]]></journal-title>
<abbrev-journal-title><![CDATA[Iatreia]]></abbrev-journal-title>
<issn>0121-0793</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Antioquia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0121-07932016000300270</article-id>
<article-id pub-id-type="doi">10.17533/udea.iatreia.v29n3a02</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Uso adecuado de antibióticos en pacientes con exacerbaciones de EPOC atendidos en un hospital de Medellín, Colombia]]></article-title>
<article-title xml:lang="en"><![CDATA[Appropriate use of antibiotics in patients with exacerbations of chronic obstructive pulmonary disease (COPD) treated in a hospital at Medellín, Colombia]]></article-title>
<article-title xml:lang="pt"><![CDATA[Uso adequado de antibióticos em pacientes com exacerbações de EPOC atendidos num hospital de Medellín, Colômbia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pineda-Paternina]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mejía-Arboleda]]></surname>
<given-names><![CDATA[Luisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Serna-Patiño]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santana-Vélez]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valencia-Gómez]]></surname>
<given-names><![CDATA[Yeliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villegas-Gil]]></surname>
<given-names><![CDATA[Vivian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caicedo-Ruiz]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jaimes]]></surname>
<given-names><![CDATA[Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Universitaria San Martín  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Antioquia  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2016</year>
</pub-date>
<volume>29</volume>
<numero>3</numero>
<fpage>270</fpage>
<lpage>279</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0121-07932016000300270&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0121-07932016000300270&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0121-07932016000300270&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo:  evaluar la adherencia a las guías de uso de antibióticos en pacientes con EPOC exacerbada y explorar la asociación entre dicha prescripción y los desenlaces clínicos.  Métodos:  estudio de cohorte retrospectivo con pacientes admitidos entre el 1 de enero del 2010 y el 31 de diciembre del 2012 con diagnóstico de EPOC. Se registraron variables sociodemográficas, clasificación espirométrica, uso de oxígeno domiciliario, exacerbaciones en el último año, uso reciente de antibióticos, necesidad de ventilación mecánica, vacunación previa, comorbilidades, presentación clínica, indicación para el uso de antibióticos, tratamiento y estado al alta.  Resultados:  de 419 pacientes 59 % (n = 247) eran mujeres, la mediana de la edad fue de 76 años, 61,8 % tenían diagnóstico clínico, 74,7 % tenían instaurado algún tratamiento ambulatorio y 11 % habían sido tratados anteriormente para exacerbación de EPOC. De 170 pacientes con indicación para el uso de antibióticos hubo prescripción en 140 (82 %), mientras que se les formularon a 118 (47,4 %) de los 249 que no cumplían ningún criterio para el uso de los mismos. Se encontró una mayor tasa de mortalidad en el grupo que requería antibióticos.  Conclusiones:  se observó un aceptable nivel de adherencia a las guías en el uso de antibióticos en los casos indicados. Sin embargo, el porcentaje de pacientes a los que se les prescribieron antibióticos innecesariamente parece ser mayor de lo esperado y amerita investigación adicional.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[SUMMARY  Objective:  to evaluate the adherence to clinical guidelines for appropriate use of antibiotics in patients with COPD exacerbations, and to explore the association between this prescription and clinical outcomes.  Methods:  a retrospective cohort study of patients admitted with COPD diagnosis between January 1, 2010 and December 31, 2012. The following variables were recorded: socio-demographic characteristics, spirometric classification, oxygen use at home, number of exacerbations in the previous year, recent antibiotic use, previous need for mechanical ventilation, previous vaccination, comorbidities, clinical presentation, antibiotic use indications and vital status.  Results:  419 patients were included, 59 % (n = 247) were women, median age was 76 years, 62 % had clinical diagnosis, 75 % had an established outpatient management and 11 % had been previously treated for exacerbation of COPD. Out of 170 patients with any indication for using antibiotics the latter were prescribed in 140 (82 %), while 118 (47 %) of 249 patients with no criterion for their use received them. Mortality rate was higher in the group with indications for antibiotics.  Conclusions:  an acceptable level of adherence to guidelines was observed in the use of antibiotics when indicated. However, the percentage of patients in whom antibiotics were unnecessarily prescribed seems to be larger than expected and demands further investigation.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Objetivo:  avaliar a aderência às guias de uso de antibióticos em pacientes com EPOC exacerbada e explorar a associação entre dita prescrição e os desenlaces clínicos.  Métodos:  estudo de coorte retrospectivo com pacientes admitidos entre o dia 1º de janeiro de 2010 e 31 de dezembro de 2012 com diagnóstico de EPOC. Se registraram variáveis sócio-demográficas, classificação espirométrica, uso de oxigeno domiciliário, exacerbações no último ano, uso recente de antibióticos, necessidade de ventilação mecânica, vacinação prévia, comorbilidades, apresentação clínica, indicação para o uso de antibióticos, tratamento e estado à alta.  Resultados:  de 419 pacientes 59 % (n = 247) eram mulheres, a média da idade foi de 76 anos, 62 % tinham diagnóstico clínico, 75 % tinham instaurado algum tratamento ambulatório e 11 % haviam sido tratados anteriormente para exacerbação de EPOC. De 170 pacientes com indicação para o uso de antibióticos houve prescrição em 140 (82 %), enquanto que se lhes formularam a 118 (47 %) dos 249 que não cumpriam nenhum critério para o uso dos mesmos. Se encontrou uma maior taxa de mortalidade no grupo que requeria antibióticos.  Conclusões:  se observou um aceitável nível de aderência às guias no uso de antibióticos nos casos indicados. Embora, a porcentagem de pacientes aos que se prescreveram antibióticos desnecessariamente parece ser maior do esperado e merece investigaçãoadicional.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Antibióticos]]></kwd>
<kwd lng="es"><![CDATA[Adherencia]]></kwd>
<kwd lng="es"><![CDATA[EPOC]]></kwd>
<kwd lng="es"><![CDATA[Exacerbación]]></kwd>
<kwd lng="es"><![CDATA[Guías GOLD]]></kwd>
<kwd lng="en"><![CDATA[Adherence]]></kwd>
<kwd lng="en"><![CDATA[Antibiotics]]></kwd>
<kwd lng="en"><![CDATA[COPD]]></kwd>
<kwd lng="en"><![CDATA[Exacerbation]]></kwd>
<kwd lng="en"><![CDATA[GOLD Guidelines]]></kwd>
<kwd lng="pt"><![CDATA[Antibióticos]]></kwd>
<kwd lng="pt"><![CDATA[Aderência]]></kwd>
<kwd lng="pt"><![CDATA[EPOC]]></kwd>
<kwd lng="pt"><![CDATA[Exacerbação]]></kwd>
<kwd lng="pt"><![CDATA[Guias GOLD]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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