J Antimicrob Chemoth:药敏实验出来后仍使用限制性抗菌药物有何影响?

2018-03-07 应颖秋 环球医学网

发表在《J Antimicrob Chemother》的一项由沙特阿拉伯和美国科学家进行的研究,考察了治疗第3天要求限制性抗菌药物重新授权的影响。

发表在《J Antimicrob Chemother》的一项由沙特阿拉伯和美国科学家进行的研究,考察了治疗第3天要求限制性抗菌药物重新授权的影响。

背景:限制性抗菌药物的预授权是抗菌药物管理计划(ASP)的核心部分。第3天时,一般会有培养结果和临床状态等信息。研究者的目的为比较仅需要初始授权vs需要初始授权+治疗第3天重新授权的ASP。

方法:研究者进行了一项单中心、回顾性、事前事后研究。随机分组的患者的入组标准为,2012年4月~6月(干预前)和2013年相同月份(干预后)接受≥3天的限制性抗菌药物。目标样本量为166例患者。干预的定义为治疗第3天时需要重新授权限制性抗菌药物。研究者比较了干预前和干预后的限制性抗菌药物治疗天数、住院日(LOS)和院内死亡率。

结果:ASP干预与所有限制性抗菌药物治疗中位天数从5(4~9)天减少到4(3~5)天相关(P<0.001),与广谱革兰氏阴性菌药物从5(3~6)天减少到3(3~5)天相关(P<0.001),与口服万古霉素从6.5(6~7)天减少到3(3~4.5)天相关。接受>4天限制性抗菌药物的患者比例从57.8%减少到30.1%(P<0.001)。LOS从8(5~17)天减少到6(5~9)天(P=0.005),而院内死亡率未显着性改变。

结论:除了初始授权外,在治疗第3天时重新授权限制性抗菌药物的需求与限制性抗菌药物总体摄入和LOS的减少相关,而不对院内死亡率造成不良影响。

原始出处:

Eljaaly K, Elarabi S, Alshehri S, et al.Impact of requiring re-authorization of restricted antibiotics on day 3 of therapy.J Antimicrob Chemother. 2018 Feb 1;73(2):527-530. doi: 10.1093/jac/dkx384.

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    2018-05-03 xjy02
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    2018-03-09 lhlxtx
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    2018-03-08 121832a9m88暂无昵称

    学习了

    0