通过针对性治疗减少社区获得性肺炎患者的抗微生物药物过度使用:集群随机因子受控试验 (CARE-CAP) 的研究方案
Abhishek Deshpande1,2, Ramara Walker3, Rebecca Schulte4
1Center for Value-Based Care Research, Primary Care Institute, Cleveland Clinic, Cleveland, OH, USA. abhishekdp@gmail.com.
Trials
|September 16, 2023
概括
快速诊断测试和药剂师主导的降级可以减少社区获得性肺炎 (CAP) 患者的扩展谱抗生素使用. 本研究评估了这些策略,以改善抗微生物药物管理和患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 临床试验 临床试验
- 抗微生物药物管理委员会
背景情况:
- 社区获得性肺炎 (CAP) 是美国住院和使用抗生素的主要原因.
- 目前CAP的诊断方法缓慢且不敏感,导致长时间的经验性抗生素治疗.
- 这有助于增加住院时间和抗菌素耐药性.
研究的目的:
- 评估快速诊断测试和药剂师主导的缓和措施在减少CAP患者使用扩展光谱抗生素 (ESA) 的有效性.
- 评估这些干预措施的独立和联合效应.
- 为了改善抗微生物药物管理,改善患者的治疗结果,并降低医疗保健成本.
主要方法:
- 一个实用的2x2因子集群随机对照试验在12家医院进行.
- 将有超过12,000名成年CAP患者参加.
- 干预措施包括例行快速诊断测试和药剂师领导的缓和,以稳定患者的消极培养.
主要成果:
- 主要结果是暴露于扩展光谱抗生素 (ESA) 治疗的持续时间.
- 二次结果包括病毒检测,抗病毒治疗,降级率,抗生素持续时间,死亡率,ICU转移,C. difficile感染,AKI,成本和停留时间.
结论:
- 这项研究将确定早期的病原体识别和缓解是否可以安全地减少CAP中ESA的使用.
- 成功的研究结果可以提高抗微生物药物管理和患者护理.
- 结果可以为CAP管理提供临床指南.
相关概念视频
Pneumonia IV: Management
357
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
357
Pulmonary Tuberculosis V
200
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
200
Pneumonia V: Nursing management and Prevention
2.2K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.2K
Acute Pyelonephritis II: Diagnostic Studies and Management
15
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...
15
Gene Regulation in Microbial Communities: Quorum Sensing
38
Quorum sensing is a mechanism of bacterial communication that enables coordinated gene expression in response to changes in population density. This facilitates collective behaviors that enhance survival, resource acquisition, and ecological adaptation. This process relies on small signaling molecules called autoinducers that accumulate as bacterial populations grow. When a critical threshold concentration of autoinducers is reached, bacterial cells collectively modify gene expression,...
38
Combined Effects of Drugs: Synergism
4.0K
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...
4.0K


