在经过剖腹产分娩的有报道的β-乳糖过敏的产妇患者中优化塞法林预防
Helen Genis1, Melinda Li2, Melanee Eng-Chong3
1Department of Medicine, University of Toronto, Toronto, ON.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
|May 28, 2023
概括
过敏史工具改善了剖腹产患者对β-乳糖过敏的塞法林的使用. 这种过敏澄清算法导致了适当的外科手术期间抗生素预防的持续增加.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 过敏和免疫学 过敏和免疫学
背景情况:
- 在接受剖腹产的患者中,β-乳糖过敏很常见.
- 由于报告的β-乳酸过敏,不适当地避免服用塞法林,可能导致低于最佳的预防.
- 优化抗生素选择对于预防手术部位感染至关重要.
研究的目的:
- 评估过敏史指导算法对外科手术期间使用塞法佐林的影响.
- 评估基于证据的Cefazolin过敏澄清处方工具 (ACCEPT) 在优化抗生素预防方面的有效性.
- 在算法实施后,以确定过敏反应和手术部位感染的变化.
主要方法:
- 由一个多学科团队开发和实施ACCEPT工具.
- 在基线和干预期间每月使用塞法林的细分回归分析.
- 收集和分析有关术后过敏反应和手术部位感染的数据.
主要成果:
- 塞法林的使用量从基线时的52%,在干预期内显著增加到87%.
- 塞法林使用的增加是统计学上显著的 (发生率比1.62,P = 0.002).
- 在实施两年后,塞法林的使用仍然很高 (92%),过敏反应或感染的增加很小.
结论:
- 一个简单的过敏史指导的算法有效地增加了产科患者的外科手术期间的塞法林预防.
- ACCEPT工具在优化对β-乳酸过敏患者的抗生素处方方面表现出持续的有效性.
- 算法实施是改善抗生素使用和患者安全的可行策略.
相关概念视频
01:21Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
01:26Urine Studies II: Urine Culture and Sensitivity Test
65
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
65
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
20
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
20
01:27Combined Effects of Drugs: Synergism
4.1K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
4.1K
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
17
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
17
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
527
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
527