减少眼科抗生素用于儿童非严重结膜炎的使用
Thresia Sebastian1,2,3, Josh Durfee4, Nancy Wittmer4
1Department of Pediatrics, Denver Health and Hospital Authority, Denver, Colorado, USA.
Journal of the Pediatric Infectious Diseases Society
|September 11, 2023
概括
一项质量改善干预措施显著减少了对儿科结膜炎的抗生素处方. 这种方法并没有增加治疗失败率,表明在儿童中有效的抗生素管理.
科学领域:
- 儿童传染病 儿童传染病
- 改善医疗保健的质量.
- 眼科医生 眼科 眼科
背景情况:
- 对儿科结膜炎的抗生素过度处方是一个重大问题.
- 系统级质量改善 (QI) 干预措施对于优化抗生素使用至关重要.
研究的目的:
- 评估一项多方面的QI干预措施,旨在减少儿童结膜炎中不必要的眼科抗生素使用.
- 评估干预对抗生素处方率,治疗失败和医疗保健利用率的影响.
主要方法:
- 实施了多方面的QI干预,包括临床途径,护士协议,EHR修改和教育材料.
- 一个多次中断的时间序列模型分析了2018年11月至2022年12月期间6个月至17岁儿童的数据.
- 费舍尔的精确测试比较了不同时间段和治疗组之间的结果.
主要成果:
- 从干预前期到干预后期,眼科抗生素的使用量下降了18.8%.
- 这项干预措施导致处方额外减少了2.7%,特别是在年幼的儿童中.
- 治疗失败在接受眼科抗生素 (20.0%) 的儿童中比未接受眼科抗生素 (17.9%) 的儿童更为常见.
结论:
- QI干预有效地减少了对儿科结膜炎的眼科抗生素处方.
- 减少抗生素使用的结果没有增加治疗失败率或医疗保健利用率.
- 这项研究突显了在儿科眼科中对抗生素管理的系统级方法的成功.
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