在患有呼吸道感染的患者中,在情节内重复处方抗生素:基于人口的队列研究
Arief Lalmohamed1, Roderick P Venekamp2, Albert Bolhuis3
1Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands; Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
The Journal of infection
|March 10, 2024
概括
对呼吸道感染 (RTIs) 的重复抗生素处方很常见,特别是在成年人中较低的RTIs. 针对这些在剧集内重复处方的目标对抗微生物药物管理至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗菌药物管理经常忽视在单个疾病发作中重复处方抗生素.
- 专注于初始处方错过了优化呼吸道感染抗生素使用的机会.
研究的目的:
- 为量化发生在主治医疗中RTIs的反复抗生素处方的事件.
- 为了确定与这些重复处方相关的患者和感染相关因素.
主要方法:
- 在英格兰使用临床实践研究数据链接 (CPRD) 进行基于人口的队列研究.
- 在2018年3月至2022年2月期间,分析了905,964例RTI病例,其中包括抗生素处方.
- 按年龄和RTI类型进行分层分析,采用多变量逻辑回归和主要组件分析.
主要成果:
- 近20%的成人下RTI发作和10.5%的上RTI发作涉及重复的抗生素处方.
- 在儿童中,重复处方发生在约10%的发作中,无论RTI类型如何.
- 频繁的RTI相关的GP访问和先前的重复处方是关键风险因素;年轻 (<2) 和老年 (65+) 的成年人也面临更高的风险.
结论:
- 在剧集内重复使用抗生素占RTIs抗生素处方的很大一部分.
- 处方相同的抗生素类别的重复处方提供不太可能的临床益处.
- 这些重复处方是未来抗微生物药物管理计划的重要目标.
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