儿童急诊室的尿路感染抗生素处方实践:这是一个值得解决的问题吗?
Jordan Kelly1, Trevor Toy2, Deonne Dersch-Mills1
1PharmD, is with Pharmacy Services, Alberta Health Services, Calgary, Alberta.
The Canadian journal of hospital pharmacy
|September 28, 2023
概括
塞法莱克辛或尼特鲁福兰能有效地治疗了大多数儿科下尿路感染 (UTI). 对上部尿路感染的最佳抗生素选择需要进一步调查,因为目前的治疗持续时间往往超过指导方针.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物药物管理委员会
- 临床微生物学 临床微生物学
背景情况:
- 儿童尿路感染 (UTI) 存在重大诊断和治疗挑战.
- 优化抗生素选择对于有效治疗和预防耐药性至关重要.
研究的目的:
- 确定最不广泛的口服抗生素,覆盖80%的病原体,导致加拿大儿科急诊室的下部和上部尿路感染.
- 为儿童尿路感染提供基于证据的抗生素处方信息.
主要方法:
- 儿童被诊断患有尿路感染并接受口服抗生素治疗的回顾性病例系列.
- 分析尿液培养结果和抗生素敏感性模式.
- 包括2020年9月至2021年2月期间从加拿大儿科急诊室出院的患者.
主要成果:
- 塞法莱克辛 (85.3%) 和尼托福兰 (80.0%) 对较低的尿路感染病原体具有很高的敏感性.
- 塞菲西 (94.7%) 和三甲-硫甲 (76.0%) 对上部尿路感染病原体的覆盖率很好.
- 平均抗生素持续时间为下部尿路感染的8.3天,上部尿路感染的9.1天,下部尿路感染的治疗时间往往超过建议.
结论:
- 塞法列克辛或尼托福兰是大多数儿科下部泌尿道感染的合适实证选择.
- 关于塞法列克辛最小抑制度的进一步数据可以指导其在上部尿路感染中的使用.
- 目前针对儿科尿路感染,特别是下部尿路感染的抗生素治疗持续时间可能超过指南建议.
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