在儿科急诊室减少无并发性尿路感染的抗生素持续时间
Gagandeep K Kooner1,2, Marissa Bass1,3, Vivek Saroha1,4
1Children's Healthcare of Atlanta, Atlanta, Georgia.
Hospital pediatrics
|March 27, 2024
概括
小儿无并发性尿路感染 (uUTI) 的短期抗生素治疗是有效的,并促进了抗生素管理. 一个质量改进项目成功地增加了急诊室的短期处方.
科学领域:
- 儿科急救医学 儿科急救医学
- 传染性疾病 传染性疾病
- 提高质量 提高科学 提高质量
背景情况:
- 在24个月以上的儿童中,短期抗生素治疗 (3-5天) 无并发性尿路感染 (UTI) 与较长的疗程同样有效.
- 这种方法支持抗生素管理,减少不必要的抗生素暴露.
- 在儿科急诊室 (ED),只有13%的符合条件的尿路感染患者接受了短期抗生素处方.
研究的目的:
- 在12个月内,将儿科UTI的短期抗生素处方率从13%提高到50%以上.
- 评估干预措施对儿童EDUTI的抗生素处方实践的影响.
- 通过监测患者对尿路感染的再访来评估减少抗生素持续时间的安全性.
主要方法:
- 一个在2021年1月至2022年8月期间进行的质量改进项目,不包括复杂的尿路感染.
- 干预措施包括提供者教育,实践反和电子健康记录 (EHR) 修改.
- 使用p图表追踪了接受短时间抗生素治疗的儿童比例;计算了抗生素节省日;分析了14天尿路感染复诊率.
主要成果:
- 干预后治疗短时间抗生素治疗尿路感染的儿童比例从13%增加到91%,超过了2个月内50%的目标.
- 总共节省了2619天的抗生素治疗.
- 在14天内,培养阳性UTI的复诊率很低 (0.6%) 并没有显著增加.
结论:
- 实施教育,反和EHR变化有效地减少了ED中儿科UTI的抗生素持续时间.
- 这项质量改进计划在不影响患者安全的情况下实现了目标,稳定的复诊率证明了这一点.
- 成功的干预措施有可能扩展到更广泛的年龄组和其他门诊机构.
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