Aplicación de la teoría de decisión racional en la selección de un antibiótico

We have used the theory of the rational decision in the selection of an antibiotic in our hospital for the empirical treatment of pneumonias of a communal origin in patients aged over 65 years with risk pathologies. We identified 9 possible antibiotics. The criteria of evaluation were their activity against various germs, toxicity, dosage schedule, cost and administration routes. These criteria were evaluated by means of a survey of internists, pneumologists, emergency service doctors and pharmacists. The antibiotic that achieved the highest score was doxycycline, although it did not meet the second most highly rated criterion in the survey, which was absence of toxicity. The second-placed one was cefuroxime, which does meet it. Surprisingly, cefonicid, which was put forward by several of the agents surveyed, was placed in eighth position. On the basis of the results we conclude that this method may be useful in drug selection and we have decided to recommend the inclusion of cefuroxime in the Pharmacological Guide of the hospital.