指示性实验室评论对处方反应对阳性喉拭子培养物的影响
Max Bloomfield1,2,3, Koen van der Werff1, Sue Todd3,4
1Department of Microbiology, Wellington Southern Community Laboratories, Wellington, New Zealand.
The Journal of antimicrobial chemotherapy
|December 15, 2023
概括
在喉抽样报告中添加评论显著减少了A组链球菌和Streptococcus dysgalactiae亚种的抗生素处方时间. 在没有急性类风湿性发烧风险因素的患者中,同样存在的感染.
科学领域:
- 传染性疾病 传染性疾病
- 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:
- 当地指导方针建议在没有急性类风湿性发烧 (ARF) 风险因素的患者中为阳性喉拭片限制抗生素的使用.
- 尽管有指导方针,10天的抗生素疗程通常被处方为A组链球菌 (GAS) 和链球菌 dysgalactiae亚种. 喉抽样,同样性 (SDSE) 阳性喉抽样.
- 一个抗菌药物管理倡议涉及向阳性喉拭片培养 (TSC) 报告添加评论,以指导处方.
研究的目的:
- 评估对积极的TSC报告添加评论对抗生素处方持续时间的影响.
- 评估干预后对GAS和SDSE感染抗生素疗程长度的变化.
主要方法:
- 从2021年10月到2023年3月的社区TSC结果和抗生素发行数据的回顾性分析.
- 与抗生素发行记录匹配的TSC结果,不包括以前经验性抗生素使用的患者.
- 在没有ARF风险因素的患者中,在TSC报告后5天内分发的分析抗生素持续时间.
主要成果:
- GAS阳性TSC的中位抗生素持续时间从10天降至7天 (P <0.01).
- 对SDSE阳性TSC的抗生素持续时间中位数从7天减少到0天 (P <0.01).
- 接受10天抗生素疗程的患者比例在GAS (63.0%至37.0%) 和SDSE (41.2%至14.6%) 均显著下降.
结论:
- 在积极的TSC报告中嵌入的直接处方建议有效地改善了符合指南的抗生素处方.
- 该干预措施在减少特定细菌喉感染不必要的抗生素持续时间方面取得了显著的成功.
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