Endocarditisを予防するために,抗生物質の予防の使用について,患者に医師の勧告
1Cardiovascular Division, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
JAMA
|June 29, 2000
まとめ
感染症性内心炎 (IE) 予防のための医師の指示は,ガイドラインと一致していましたが,低リスクの患者では過剰使用,中程度のリスクの患者では過度の使用が発生しました. 患者と医師の教育は,アメリカ心臓協会の勧告をよりよく遵守するための鍵です.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
背景:
- 1997年のアメリカ心臓協会 (AHA) のガイドラインは,従順性を改善するために,感染症性内心炎 (IE) 予防療法を簡素化しました.
- これらの更新されたAHAの推奨事項への遵守,特にエコーカルディオグラフィのリスクが確認された患者の遵守は未評価のままです.
研究 の 目的:
- IE予防の推奨と実際の使用の一致性を評価する.
- エコーカルディオグラフィーを受けている患者によって報告されたIE予防の活用を評価する.
主な方法:
- 外来心声検査を受けた適格な患者218人 (80%の応答率) に調査を実施した.
- 患者は,エコーカルディオグラフィのリスクカテゴリーに基づいて,IE予防に関する医師の指示を報告しました.
主要な成果:
- 予防接種を指示された108人の患者のうち,65.7%が指示を受けたと報告した.
- 高リスク患者 (88.9%) と中程度のリスク患者 (61.1%) は指示を受けたと報告し,軽微リスク患者の26.4%は指示を受けたと報告した.
- 全体として,患者の45.9%がIE予防のための医師の指示を受けたと報告しました.
結論:
- ほとんどの患者がAHAのガイドラインと一致する指示を報告したにもかかわらず,軽微なリスクのグループでは過剰な使用,中等リスクのグループでは過度の使用が一般的でした.
- AHAのIE予防勧告への遵守の改善は,継続的な医師と患者の教育を通じて達成することができます.
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