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. 2019 Feb;41(2):97-101.
doi: 10.1055/s-0039-1678590. Epub 2019 Feb 20.

The Use of Mobile Educational Tools to Improve Antimicrobial Prescription for the Treatment of Acute Pyelonephritis in Pregnancy: A Retrospective Cross-sectional Study

Vicente Sperb Antonello  1   2 , Marjane Caroline Cunegatto  3 , Elisa Tasca Rosin  3 , Júlia Xavier Castilhos  3 , Fabrícia Gamba Beduschi  3 , Daniela Benzano Bumaguin  4 , Ivan Carlos Ferreira Antonello  5 , Mirela Foresti Jimenez  5
Affiliations

The Use of Mobile Educational Tools to Improve Antimicrobial Prescription for the Treatment of Acute Pyelonephritis in Pregnancy: A Retrospective Cross-sectional Study

Vicente Sperb Antonello et al. Rev Bras Ginecol Obstet. 2019 Feb.

Abstract
in English, Portuguese

Objective: To analyze the prescription of antimicrobial agents for pregnant women admitted into the obstetrics service who presented with acute pyelonephritis.

Methods: Three cross-sectional studies were performed comparing the prescription of antimicrobials for pyelonephritis in pregnant women in the time periods evaluated (2010-2011: 99 patients evaluated; 2013: 116 patients evaluated; 2015: 107 patients evaluated), at the Hospital Fêmina, Porto Alegre, in the state of Rio Grande do Sul, Brazil. The analysis was performed before and after the promotion of an institutional protocol for the treatment of pyelonephritis during pregnancy, and on a third occasion after the introduction of a smartphone-based mobile educational tool.

Results: The evaluation of the prescribing physicians and the adequacy of the prescriptions between the different periods studied revealed a significant increase in appropriate conduct for the choice of antimicrobial (2010: 83.8%; 2013: 95.7%; and 2015: 100%), route of administration (2010: 97%; 2013: 100%; and 2015: 100%), and interval (2010: 91.9%; 2013: 95.7%; and 2015: 100%), following the introduction of the protocol, and again after the implementation of the software application with orientations on the antimicrobial treatment.

Conclusion: The use of specific mobile applications should be encouraged to attain a better quality and accuracy in prescriptions and to include strategies that not only reduce the risk of negative outcomes, but also improve the quality of care and treatment for maintaining the health both of the mother and of the baby.

Objetivo: Analisar a prescrição de antimicrobianos para gestantes admitidas no serviço de obstetrícia que apresentaram pielonefrite aguda. MéTODOS: Foram realizados três estudos transversais comparando a prescrição de antimicrobianos para pielonefrite em gestantes nos períodos avaliados (2010–2011: 99 indivíduos avaliados; 2013: 116 indivíduos avaliados; 2015: 107 indivíduos avaliados), no Hospital Fêmina, Porto Alegre, RS, Brasil. A análise foi realizada antes e após a promoção de um protocolo institucional para o tratamento da pielonefrite durante a gravidez e, em uma terceira ocasião, após a introdução de uma ferramenta educacional móvel para uso por smartphone.

Resultados: A avaliação das prescrições médicas e a adequação das prescrições entre os diferentes períodos estudados revelaram um aumento significativo na conduta adequada para a escolha do antimicrobiano (2010: 83,8%; 2013: 95,7%; e 2015: 100%), via de administração (2010: 97%; 2013: 100%; e 2015: 100%) e intervalo (2010: 91,9%; 2013: 95,7%; e 2015: 100%), após a introdução do protocolo, e novamente após a implementação do aplicativo com orientações sobre tratamento antimicrobiano. CONCLUSãO: O uso de aplicativos móveis específicos deve ser incentivado para obter melhor qualidade e precisão nas prescrições e incluir estratégias que não apenas reduzam o risco de resultados negativos, mas que também melhorem a qualidade dos cuidados e do tratamento para manter a saúde conjunta da mãe e do bebê.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Layout of ATB Femina mobile application.
Fig. 2
Fig. 2
Venn diagram about the variation of gynecology and obstetrics practitioners during the study.
Fig. 3
Fig. 3
Comparative analysis of appropriate prescriptions in the three periods studied.
See this image and copyright information in PMC

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