在FDA监管后,在医院尿路感染中使用抗生素
Aaron Brant1, Patrick Lewicki2, Xian Wu2
1Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA. aab9038@med.cornell.edu.
Journal of general internal medicine
|December 26, 2023
概括
美国食品和药物管理局的"黑子"警告导致尿路感染 (UTI) 的诺基诺使用减少. 这种转变与诺基诺隆耐药性降低和 ceftriaxone处方增加有关.
科学领域:
- 传染性疾病 传染性疾病
- 药物监督 药物监督 药物监督
- 抗微生物药物管理委员会
背景情况:
- 美国食品和药物管理局 (FDA) 在2008年发布了关于诺基诺风险的"黑子"警告,随后在2011年,2013年和2016年进行了更新.
- 这些警告强调了与诺基诺抗生素使用相关的重大安全问题.
研究的目的:
- 分析2000年至2020年间在医院治疗的尿路感染 (UTI) 处方抗菌剂的趋势.
- 评估FDA"黑子"警告对诺基诺隆利用和耐药性模式的影响.
主要方法:
- 通过使用中断时间序列分析进行了横截面研究.
- 数据包括2000年1月至2020年3月的近1000万名患有尿路感染诊断的患者.
- 评估了每月使用的抗生素 (诺基诺和非诺基诺) 和可用培养物的诺基诺耐药性.
主要成果:
- 诺基诺用于尿路感染的使用率显著下降,从2008年7月的61.7%降至2020年3月的11.7%.
- 与此同时,在同一时期, ceftriaxone 的使用量从 26.4% 增加到 63.6%.
- 诺基诺耐药性下降了28.9% (2009-2020年),而2008年FDA的警告与诺基诺使用量显著下降有关.
结论:
- 美国食品和药物管理局 (FDA) 的"黑子"警告与对尿路感染的诺基诺处方大幅减少有关.
- 这种下降与诺基诺隆耐药性的下降以及使用替代抗生素 (如氏) 的增加相关.
- 对一种抗生素类别的限制可能会导致对替代品的依赖增加,可能会改变耐药性动态.
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