宽频抗生素降级对重症患者结果的影响:回顾性队列研究
Namareq Aldardeer1, Ismael Qushmaq2, Bashayer AlShehail3
1Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, MBC J-11, P.O. Box 40047, Jeddah, 21499, Saudi Arabia. aldardeern@hotmail.com.
Journal of epidemiology and global health
|June 9, 2023
概括
在重症患者中降低抗生素升级并没有显著减少超级感染. 虽然降级缩短了感染复发的时间,但导致了更长的ICU和住院时间.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 在重症患者中抗生素降级 (ADE) 仍然存在争议.
- 现有的研究主要集中在死亡率上,对超级感染率的数据有限.
- 这项研究研究了ADE对持续的宽谱抗生素治疗对ICU中超级感染和其他结果的影响.
研究的目的:
- 为了确定抗生素降级与继续治疗相比对重症患者超级感染率的影响.
- 评估二次结果,包括30天感染复发,ICU停留时间,住院时间和死亡率.
主要方法:
- 一项回顾性队列研究,涉及 250 名在重症监护室 (ICU) 接受宽谱抗生素至少 48 小时的成年患者.
- 患者被分为两组:抗生素降级 (ADE) 和继续治疗.
- 主要结局是超级感染率;次要结局包括感染复发,ICU/住院时间长度和死亡率.
主要成果:
- 与继续治疗组 (10.4%) 相比,ADE组的超级感染率在数值上较低 (6.4%),但这种差异在统计学上并不显著 (P=0.254).
- ADE组的感染复发时间较短 (P=0.045) 但在ICU (P=0.002) 和住院时间 (P=0.016) 显著较长.
- 在ADE组 (平均7.2天) 与继续治疗组 (平均10.3天) 之间,抗生素的停用较早发生 (P=0.001).
结论:
- 在重症患者的抗生素降级和继续使用广谱抗生素之间,没有观察到超级感染率的显著差异.
- 需要进一步的研究来探索快速诊断与抗生素缓解策略的作用,特别是在高抗菌素耐药性的背景下.
- 这些发现表明,降级的好处与风险之间存在潜在的权衡,例如长时间住院.
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