在COVID-19时代,错过了抗真菌管理的机会
Brandon K Hawkins1, Samantha D Walker2, Mahmoud A Shorman3
1College of Pharmacy, University of Tennessee Health Science Center, Knoxville, TN 37920, USA.
Antibiotics (Basel, Switzerland)
|September 28, 2023
概括
在COVID-19期间,除了isavuconazonium外,抗真菌药物的使用保持稳定,尽管危急病患者的真菌感染风险增加. 抗菌药物管理是适当的抗真菌处方的关键.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在COVID-19期间,抗菌剂的使用激增,超过了细菌共感染率.
- 危急的COVID-19患者面临肺部阿斯伯吉洛症的风险增加.
- 在这些高风险人群中,抗真菌的使用报告不足,特别是在大流行后期.
研究的目的:
- 为了比较COVID-19大流行之前和期间在医疗重症监护室中使用的活性菌药物.
- 评估特定抗真菌剂的使用情况的变化,包括脂质体安福特里辛B,安尼杜拉金,伊萨武可纳,波萨可纳和沃里可纳.
主要方法:
- 单中心,人口层面的队列分析.
- 月度抗真菌药物使用率在基线期 (2019年4月至2020年3月) 和大流行期 (2020年4月至2022年11月) 之间进行了比较.
- 在这两个时期之间,诊断方式保持一致.
主要成果:
- 总体而言,抗真菌药物的使用与基线没有显著差异,除了isavuconazonium,其显著增加 (p = 0.009).
- 没有观察到诊断方法的变化.
- 处方模式可能反映出人们对COVID-19相关的肺炎 (CAPA) 的担忧.
结论:
- 对于重症COVID-19患者的抗真菌处方模式基本保持不变,但对 isavuconazonium.有一个显著的例外.
- 提高对CAPA流行率和死亡率的认识可能会影响抗真菌处方.
- 抗微生物药物管理计划需要增强的工具来优化抗真菌使用.
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