J González’s research while affiliated with Stock Market Studies Institute and other places

What is this page?


This page lists works of an author who doesn't have a ResearchGate profile or hasn't added the works to their profile yet. It is automatically generated from public (personal) data to further our legitimate goal of comprehensive and accurate scientific recordkeeping. If you are this author and want this page removed, please let us know.

Publications (14)


Importance of the antimicrobial spectrum and the bacterial resistances in the antibiotic choice for the treatment of pediatric patients with comunitary infections
  • Article

April 2009

·

20 Reads

·

10 Citations

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

·

J González

·

·

[...]

·

J Prieto

This study aimed to know the importance of the antimicrobial spectrum and the bacterial resistances for the antibiotic choice in the extrahospitalary pediatric area, at the same time that establish the relationship with others therapeutics parameters. Cross-sectional, observational study within the MUSA (Improvement of Use of Antimicrobial Agents in Primary Health Care) Project made by personal interview of 210 pediatrician doctors randomly selected with national representation. This target is included in a bigger universe (855 doctors) representative of the most doctors responsible of the antibiotic prescriptions in the extrahospitalary area (sample error of the 3.3% for a 95% confidence interval and maximum response dispersion: p=q=50). The results of the pediatric study were subjected to a comparative analysis with the results of a similar study made ten years ago and with the global results of the general study. The questionnaire used for the interview had two clearly different parts: in the first part, the questions were open with the objective to get spontaneous answers from the participants; the second part had questions with suggested answers. Clinical efficacy is the most spontaneously valued issue by the Spanish pediatricians when it comes to choosing an antimicrobial agent; efficacy is followed by tolerance/safety and posology. Antimicrobial spectrum is mentioned by one out of 4-5 pediatricians that have participated in the study (21.9%), while the bacterial resistances are only mentioned by a 3.8%. In a suggested level, clinical efficacy is still the most valued parameter, being identified by 7 out of 10 interviewed with the bacterial eradication. In this case, the antimicrobial spectrum is the following parameter on significance, appearing as a synonym of "activity against specific microorganisms" in 2 out of 3 cases. In relation to his own evaluation, 3 out of 4 pediatricians say they take "a lot" of the bacterial resistances into consideration, who are mostly understood as "global rate" for 5-6 out of 10 interviewed, whether the resistance showed by the pneumococcal is what worried the most to 4 out of 10 of them. This importance given to the bacterial resistances at the second part of the study contrasts with the low consideration showed when it is compared with other parameters and the valoration is treated in a spontaneous way. In relation to a similar study realized on 1997 (Urano Proyect), we observe that clinical efficacy has replaced tolerance/safety as a parameter to bear in mind, probably as a consequence of more experience and confidence with the most important antimicrobial agents in the antibiotic prescriptions in podiatry. On the other hand, the bacterial resistances still being left out on the pediatricians spontaneous consideration, a fact that is shared with the majority of the collectives participating on the general study. The rest of the parameters stay in a similar way. Is necessary to emphasize at the importance of bacterial resistances in the antimicrobials rational use on the pediatric patient. As the antimicrobial tolerance profile has been improving in the last ten years, clinical efficacy, understood as "bacterial eradication" has became the most determining parameter when choosing antimicrobial agents.


A day in Spanish microbiology. Descriptive study of the activity of the clinical microbiology departments

January 2009

·

32 Reads

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

The laboratory is an essential part of the work in the Clinical Microbiology Department. This study has aimed to measure the activity of these laboratories. A survey was self-administered on the activity occurring during one work day by each hospital in October 2007. Thirty six hospitals reported 14,076 tests. Serology was the most frequently reported test (30.3%) followed by urine culture (27.8 %), blood tests (13.2 %), respiratory tract samples (8%), feces (7.1%), urethral (5.8%), skin (5.3%) and cerebrospinal fluid (2.6%). According to species, 73.2% of the isolates were bacteria (22.9 % were positive), 8.9% were virus (17% positive), fungi 8.1% (25.2% positive), and 5.5% mycobacterias (5.9% were positive) and parasite 4.5% (12.5% positive). Susceptibility test were performed by automatic methods (62.3%) followed by diffusion test (27.1%) and E-test (9.1%). A total of 5.6% of the susceptibility tests showed in vitro resistance to antibiotics. Fungi were identified in 108 isolates. Candida and Aspergillus were the most frequent genus (85.1% and 8.3%, respectively). Origins of the samples were: lower respiratory tract (32.4 %), genital tract (24.1 %), urine (10.2 %), blood (10.2 %) and skin (10.2 %). Twelve identification techniques were used, the most frequent being the morphological test (54.8%) and biochemical test (39.7%). Broken down by departments, 20.4% were sent from the ICU, 16.7% from surgery, 29.6% from medicine and 18.5% from primary care. Although the workload of the laboratories has been measured in this work, aspects such as specimen manipulation, clinical advice and research were not considered.


Behavior of de Primary Care physicians in the treatment of community infections
  • Article
  • Full-text available

April 2008

·

89 Reads

·

3 Citations

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

This study aimed to evaluate the behavior of the physicians who attend to patients with community infections who are responsible for most of the antibiotic prescriptions made in the community setting. Furthermore, the evolution over the last 10 years in regards to the treatment habits of the most frequent infections in Primary Health Care (PHC) was studied and prescription behaviors were analyzed in relationship to the acquaintance and attitude of the participating physicians. A data collection sheet from 1,411 prescriptions made by 855 physicians from different specialties was used to conduct the study. This represents a statistically significant sample nationwide both from the point of view of the physicians involved in the treatment of infectious diseases in PHC as well as regarding to the prescriptions they have written. The study reveals the amplitude of respiratory and pararespiratory disease with oral antimicrobial agents, particularly beta-lactamics, and the significant advance in the last 10 years in the use of amoxicillin and clavulanic acid as treatment of choice. Treatment duration was somewhat longer while the number of containers prescribed was less than in the previous study. This would be related to the use of more spaced doses of the antimicrobial agents. Furthermore, the study reveals some discrepancies between attitudes and events of the physicians in the approach to certain diagnoses. Key words: Behavior. Primary care physicians. Prescription. Antimicrobials agents.

Download

Antimicrobial selection criteria evaluation by family doctors and general practitioners

April 2008

·

19 Reads

·

4 Citations

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

This study has aimed to know the criteria used by the Spanish medical practitioners/family doctors (MP/FD) when choosing an antimicrobial agent in their daily practice and to compare it with that existing one decade ago. This is an observational, cross-sectional study performed with a structured personal interview to 450 MP/FDs randomly chosen with representativeness on the national level. The field work was made by specialized personnel in the last quarter of the year 2006. A 95.5% confidence interval margin was proposed, with a sample error = 4.7%, for maximum dispersion response (p=q=50). The parameter considered most when choosing an antibiotic treatment (spontaneous response) is clinical efficacy (two out of every three doctors). Clinical efficacy is following by the dosage regime and tolerability/safety, which was the principal parameter expressed ten years ago. Following these are antibacterial spectrum, administration route, price and bacterial resistances. However, they considered that the latter significantly influence clinical efficacy and when they are not relativized with other parameters, the doctors state that they take them into account <much/a lot>. It seems that the opinion of the patient is usually considered and that the protocol, scientific information and expert's opinions are the principal sources of information considered when prescribing an antimicrobial agent. Amoxicillin/clavulanate is the antibiotic drug of choice in all upper and lower respiratory tract infections. There is overestimation of the bacterial etiology in throat infections and acute bronchitis and S. pyogenes to betalactamic antibiotics. It is concluded that knowledge of the Spanish MP/DF regarding antimicrobial therapy has improved in recent years and that clinical efficacy, related with bacterial eradication and not only with clinical remission, is the factor that should be considered when choosing an antibiotic.


Un día en la Microbiología española. Estudio descriptivo de la actividad de los Servicios de Microbiología Clínica

January 2008

·

27 Reads

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

Introducción. El laboratorio es una parte fundamental del trabajo de los Servicios de Microbiología Clínica (SMC). El objetivo de este estudio es medir la actividad de estos laboratorios. Material y métodos. Encuesta autoadministrada sobre la actividad de un día de trabajo durante octubre de 2007. Resultados. Los 36 hospitales reportaron 14.076 test, siendo el más solicitado la serología (30,3 %), seguido por cultivo de orina (27,8%), hemocultivo (13,2 %), muestras respiratorias (8%), heces (7,1%), uretra (5,8%), piel (5,3%) y líquido cefalorraquídeo (2,6%). Por tipo de microorganismo, el 73,2 % de las muestras correspondía a bacterias (22,9 % fueron positivas), el 8,9 % a virus (17 % de positivos), el 8,1% a hongos (rendimiento: 25,2%), el 5,5% a micobacterias (rendimiento: 5,9%) y a parásitos el 4,5% (positivos: 12,5%). Los sistemas automáticos han sido los más empleados en test de susceptibilidad (62,3 %) seguidos de test de difusión (27,1%) y E-test (9,1%). El 5,6% de los antibiogramas demostraron resistencia in vitro a los antibióticos. Se han identificado hongos en 108 aislamientos, siendo los más frecuentes Candida (85,1 %) y Aspergillus (8,3%). El origen de estas muestras es: vías respiratorias bajas (32,4%), aparato genital (24,1%), orina (10,2%), sangre (10,2 %) y piel (10,2 %). Se han empleado 12 técnicas de identificación; las más frecuentes han sido las morfológicas (54,8 %) y bioquímicas (39,7 %). Por servicios se remitieron de Unidades de Cuidados Intensivos (UCI) (20,4 %), Cirugía (16,7%), Medicina (29,6%) y Atención Primaria (18,5%). Discusión. Aunque se ha medido la carga de trabajo de los laboratorios, no se evaluaron aspectos como el procesamiento de los especímenes, la asesoría o la investigación



Figura 1 1. Microorganismos más frecuentes involucrados. Diagnóstico: bronquitis aguda. 
Figura 2 2. Características principales a tener en cuenta a la hora de elegir un antibiótico. 
Knowledge and attitude of primary health care doctors in the treatment of community-acquired infections

October 2007

·

93 Reads

·

5 Citations

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

The aim of this study was to evaluate the knowledge and attitude of the doctors who attend patients with community-acquired infections and who are responsible for most of the antibiotic prescriptions in primary health care. At the same time, the evolution experienced in the last ten years in relation to the main parameters analyzed was studied. The study was conducted by personal interviews, using a structured questionnaire, administered to 855 doctors of different specialties, who make up a statistically significant nationwide sample. The study showed that in spite of the improvements in the knowledge of the microbiology of infectious diseases and the choice of antimicrobial agents, there are still certain areas that need improvement. These are, above all, in regard to the bacterial resistance problem, underevaluation of the viral etiology of certain respiratory tract infections and the somewhat condescending attitude with "visits by third parties", indulgence prescriptions and therapeutic noncompliance. Efficacy defined not only as clinical remission but also, and essentially, as antibacterial coverage, are the main parameters considered when participating physicians choose an antibiotic.



Storage of antibiotics in Spanish households

October 2006

·

35 Reads

·

34 Citations

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

This study aimed to determine how many antibiotics were stored in Spanish households, analyzing their origin and characteristics (number, antibiotic type and pharmaceutical form). In addition, some general characteristics of the "home medicine cabinet" were investigated. The study was conducted by telephone interviews with one of the heads of the family in 1,000 randomly chosen Spanish homes, but in accordance with a territorial distribution proportional to the Spanish population and to the urban and rural setting. According to the results obtained, there was at least one antibiotic packet in 37% of Spanish households, mostly corresponding (96.5%) to broad-spectrum semisynthetic penicillin (amoxycillin or clavulanic-amoxycillin). A total of 59.2% of the packets found corresponded to solid oral forms (tablets, capsules, etc.) and 40.4% corresponded to liquid oral forms (syrup, suspension, sachet). The antibiotics were mostly obtained by medical prescription (84.9%), self-medication being the origin in almost 15% of them. There was a member of the family under antibiotic treatment at the time of the study in only 30% of the households that had one or more containers. The financial evaluation of the "leftover" antibiotic doses makes it possible to estimate a cost of about 18 million euros, more than 12 million of which would have been financed by the Health Care Administration. The results show that storing of antibiotics continues to be important in Spain, even though a considerable decrease has been observed in the last 10 years. This could be related to a progressive abandonment of self-medicating attitudes.


[Antibiotics in Spanish households. Medical and socioeconomic implications. URANO Study Group]

January 1998

·

17 Reads

·

52 Citations

Medicina Clínica

To determine the storage of antibiotics in Spanish households and to analyse its source. Quantitative study carried out by telephone interview with housewives or head of the family members in 1,000 households that have been chosen at random and by agreement with a proportion of the territorial distribution of the Spanish population. In 42% of households that have been approached, one (88.1%) or more antibiotic packets were present, being a result of a doctor's prescription in two thirds of cases. In most cases (71.9%) amoxycillin was the antibiotic found. Concerning the pharmaceutical forms, 55% corresponded to solid oral (pills, tablets, capsules), 45% liquid oral forms (syrups, suspensions, sachets), whereas parenteral vials were not identified. Only in the 19% of households with antibiotic packets (8% of the total) there was a member of the family under antibiotic treatment. The economic evaluation of the non administrated antibiotic doses, present in households was about 5,000 millions pesetas. Over 3,000 millions pesetas had been financed by Health Public Administration. The storage of antibiotics in households is an important factor which increments the cost, reduces the efficiency and decreases the quality of the antibiotic treatment at the community level.


Citations (10)


... O grupo das cefalosporinas, dos macrólidos e o grupo das quinolonas foram prescritos em 8,4, 20,2 e 19,3% das situaç ões, respetivamente. Quando se comparam os resultados de vários estudos [20][21][22][23]30 encontram-se diferenças que poderão estar relacionadas com o padrão de prescrição dos médicos envolvidos, mas também, e acreditamos que com maior peso, a incidência das doenças para as quais foi prescrito antibiótico e a própria metodologia utilizada. Além disso, é natural que estudos mais recentes apresentem resultados mais ajustados ao conhecimento atual sobre a resistência bacteriana. ...

Reference:

Padrão de prescrição de antibióticos no Algarve: características do doente e dispersão da terapêutica
Comportamiento de los médicos de Atención Primaria en el tratamiento de las infecciones comunitarias

... 8---10 Antimicrobial overuse in the paediatric population has significant repercussions, as the prevalence of antimicrobial resistance is up to 30% greater in isolates in community-acquired infections compared to isolates in the hospital setting. 11,12 The aim of our study was to describe the use of antibiotics at the outpatient level in the paediatric population of Asturias, Spain, and analyse quantitative and qualitative temporal trends in antimicrobial use in the 2005---2018 period. ...

Importancia de la cobertura antimicrobiana y de las resistencias bacterianas en la elección de antibióticos en Pediatría
  • Citing Article

... Denominó al preparado recién descubierto "salvarsán" ("el arsénico que salva") y postuló su teoría: El compuesto se combina químicamente con las espiroquetas y las mata; en cambio, no reacciona con el cuerpo humano. (7,8) Doce años después (1936), los diarios atraían al lector con una noticia: Franklin Delano Roosvelt, hijo del presidente, estaba muy enfermo, infectado. Pero había más esperanzas, dado que se disponía de un medicamento capaz de matar microorganismos dentro de la corriente sanguínea. ...

La penicilina llega a España: 10 de marzo de 1944, una fecha histórica
  • Citing Article
  • January 2007

... A literatura chama a atenção para o recurso cada vez maior de antibióticos de largo espetro como a combinação de amoxicilina com ácido clavulânico, macrólidos, cefalosporinas e quinolonas 24,35 . No nosso estudo, verificámos que os antibióticos mais prescritos foram a associação amoxicilina com ácido clavulânico (21,3%), amoxicilina (13,9%), ciprofloxacina (13,36%), azitromicina (9,97%) e claritromicina (8,70%), que representam 67,3% do total dos antibióticos prescritos. ...

Conocimiento y actitud de los médicos de atención primaria en el tratamiento de las infecciones comunitarias

... A random survey of 1000 Spanish households found that 37% of them had one or more packages of antibiotics stored, but only 30% were for an active treatment. 34 The research group lead by Arias-Puente, described that 35% of patients attending the pharmacy office had antibiotics in their first-aid kit. 35 56% of patients had leftover treatment and only 11% recycled it after the Phase 2 completion. ...

Almacenamiento de antibióticos en los hogares españoles
  • Citing Article

... La mayoría de los estudios de utilización de medicamentos (EUM) sobre consumo de antibacterianos en España se han llevado a cabo en población adulta y destacan una alta exposición a antibióticos, un aumento progresivo del uso de principios activos de amplio espectro y una amplia variabilidad entre regiones sanitarias [6][7][8][9][10][11]. Existen escasos EUM sobre consumo de antibióticos en población pediátrica en nuestro país, pero no por ello, el problema es menos relevante. Se estima que en torno al 60% de los niños menores de 4 años están expuestos a antibióticos al menos una vez al año y se ha documentado hasta un 30% más de cepas resistentes en los aislamientos de microorganismos adquiridos en la comunidad procedentes de pediatría respecto a los de medicina interna [6,7,12,13]. ...

Importance of the antimicrobial spectrum and the bacterial resistances in the antibiotic choice for the treatment of pediatric patients with comunitary infections
  • Citing Article
  • April 2009

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

... 35 A study done in Spain also concluded the storage of antibiotics reduced the efficacy and quality of the treatment at the community level. 36 Leftover medications might be stored inappropriately, which could cause defects in the medication leading to ineffective treatment. Therefore, proper storage is extremely critical for the efficiency, efficacy, and safety of medicines. ...

[Antibiotics in Spanish households. Medical and socioeconomic implications. URANO Study Group]
  • Citing Article
  • January 1998

Medicina Clínica

... De acuerdo con el tipo de medicamento con mayor automedicación fueron los AINES con 41,98 % (en comparación con 50 % de la automedicación en la investigación), seguido del 16,41 % con antibióticos (28 % en la investigación) y anticonceptivos con 9,54 % (variable no valorable en el estudio). (25,26,27,28) A partir del análisis de los resultados de este trabajo y a pesar de que los porcentajes divididos por variables no son similares a los de la investigación, la alta prevalencia de la automedicación si fue similar, con un 76,71 %. (29,30) Así mismo, otro estudio realizado en la Facultad de Odontología de la UNNE, reveló que cerca del 84 % de los estudiantes reconoció haberse automedicado en alguna ocasión, afirmando que la gran parte de los medicamentos autoadministrados logró surtir el efecto terapéutico deseado, lo que coincide con el 97 % de los estudiantes de la Facultad de Odontología de la UAI que afirmaron el cumplimiento del efecto deseado del medicamento. Así mismo, los fármacos más utilizados fueron los AINE's (63 % en concreto con ácido acetilsalicílico) y los fármacos para la sintomatología musculoesquelética (dato que coincide con el 7 % de los estudiantes del estudio que se automedico con miorrelajantes). ...

Storage of antibiotics in Spanish households
  • Citing Article
  • October 2006

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

... This paradoxical effect can be explained because they give more importance to immediate efficacy or patient satisfaction (an individual point of view) over potential long-term antibiotic resistance in the population (a collective point of view). 17 Responsibility to other professionals (other pharmacists/medical staff, patients, the healthcare system or the use of antibiotics in animals) is another attitude associated with DAwMP and is common among health professionals. 15,18 A possible limitation of this study is bias caused by those who did not respond. ...

Antimicrobial selection criteria evaluation by family doctors and general practitioners
  • Citing Article
  • April 2008

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia

... As a result, treatments may often be inappropriates and promote the development of bacterial resistance (1,(4)(5)(6). Several studies have been conducted in Spain in the past 10 years that describe the behavior of health professionals in primary care with regard to prescribing antibiotics; these studies show that there is an excessive prescription of antibiotics, as well as an inappropriate use of them (7). The objectives of our study are to assess the performance of dentists and family doctors in prescribing antibiotics for the treatment of odontogenic infections, as well as determine the differences between both groups. ...

Behavior of de Primary Care physicians in the treatment of community infections

Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia