立即与延迟与没有抗生素治疗呼吸道感染
Geoffrey Kp Spurling1, Liz Dooley2, Justin Clark2
1General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Australia.
推迟用于呼吸道感染 (RTIs) 的抗生素处方可以减少抗生素的使用,而不会显著影响症状持续时间或患者满意度. 临床医生应考虑不服用抗生素或延迟服用抗生素作为RTIs立即处方的替代方案.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 过度使用抗生素治疗呼吸道感染 (RTIs) 引发了人们对副作用,成本和抗菌素耐药性的担忧.
- 延迟抗生素处方是一种减轻这些问题的策略,允许在填写处方之前,症状自然消失.
研究的目的:
- 评估与延迟RTIs抗生素处方相关的临床结果,抗生素使用,耐药性和患者满意度.
- 为了比较延迟处方与立即或没有抗生素治疗.
主要方法:
- 随机对照试验 (RCT) 的活生生的系统审查和元分析,涉及所有年龄段的参与者与RTIs.
- 在多个数据库 (CENTRAL,MEDLINE,Embase,CINAHL,Web of Science) 和临床试验注册表中进行的搜索.
- 包括12个带有3968名参与者的RCT,分析了疼痛,发烧,咳,不良反应,抗生素使用和患者满意度等结果.
主要成果:
- 对于大多数RTIs,在延迟,立即或没有抗生素策略之间没有发现临床结果 (疼痛,发烧,咳) 的显著差异.
- 与立即处方相比,延迟的抗生素显著减少了抗生素的使用 (30%与93%相比),但与没有抗生素相比,使用量增加了 (27%与13%).
- 患者满意度在延迟和即时抗生素之间是相似的,并且偏爱延迟而不是没有抗生素.
结论:
- 延迟抗生素处方是一种有效的策略,可以减少对RTIs的抗生素消费,同时保持临床结果和患者满意度.
- 对于有信心不开抗生素的临床医生来说",不使用抗生素"的策略进一步减少了抗生素的使用.
- 进一步的研究应该集中在识别高风险患者群体和改善沟通,以支持非处方策略.
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