阴性杆菌性细菌病的影响 快速诊断测试和实时临床药剂师干预实时临床药剂师干预
Abby M Kremer1, Jeannette L Bouchard1,2, Alison I Orvin1,2
1Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, NC, USA.
Journal of pharmacy practice
|October 21, 2023
概括
药剂师审查的快速诊断测试 (RDT) 并没有加快针对格拉姆阴性棒 (GNR) 细菌病的初始抗生素选择,但确实加快了生物体导向治疗的变化.
科学领域:
- 传染性疾病 传染性疾病
- 临床药房 临床药房
- 医学诊断 医学诊断 医学诊断
背景情况:
- 快速诊断测试 (RDT) 针对格拉姆阴性棒 (GNR) 细菌病的最佳实施仍未确定.
- 这项研究评估了RDT与实时药剂师通知在机构层面.
研究的目的:
- 评估 RDT 结果通知和实时临床药剂师审查对 GNR 细菌病管理的影响.
- 确定对适当抗生素治疗及其他临床结果的时间影响.
主要方法:
- 追溯,匹配的队列研究,比较历史和干预时期 (2020年9月至2022年9月).
- 包括通过BIOFIRE®血液培养识别2面板识别的GNR细菌病患者.
- 根据年龄,病原体和耐药性匹配患者;不包括多微生物感染和早期死亡率.
主要成果:
- 从格拉姆染色到适当的抗生素治疗的中位时间没有显著差异 (两组0小时).
- 显著减少了第一个生物体导向的治疗改变的中位时间 (40小时历史 vs. 11小时干预).
- 没有观察到停留时间,抗伪体治疗持续时间或住院患者死亡率的差异.
结论:
- 实时药剂师审查的RDT实施并没有减少GNR细菌病的初始适当治疗时间.
- 这种方法显著加速了针对生物体的抗生素治疗调整.
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