在早产婴儿中维持抗菌管理计划的持续有效性
Tommaso Zini1, Francesca Miselli1,2, Chiara D'Esposito3
1Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Tropical medicine and infectious disease
|March 27, 2024
概括
抗生素管理 (AS) 计划有效地减少了对出生时体重非常低 (VLBW) 婴儿的抗生素使用. 这些干预措施,包括较短的抗生素疗程,可以在新生儿重症监护病房 (NICU) 中长期维持,并持续员工参与.
科学领域:
- 新生儿科学 新生儿科学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 在新生儿重症监护室 (NICU) 中,抗生素的使用有很大差异.
- 有限的数据存在于对早产期非常低出生体重 (VLBW) 婴儿的抗菌药物管理 (AS) 计划.
- 在这个易受伤害的人群中,对AS干预措施的长期维持并未得到充分记录.
研究的目的:
- 评估在早产VLBW婴儿中的抗菌管理 (AS) 计划的可行性和长期影响.
- 通过AS干预来评估减少抗生素暴露的可持续性.
- 在NICU环境中分析不同研究时期的抗生素使用模式.
主要方法:
- 一个意大利NICU的单中心观察研究比较了三个时期:基线 (2011-2012),干预 (2016-2017) 和维护 (2020-2021).
- 在基线和干预期间之间进行了针对AS的密集员工培训.
- 在干预和维护期间之间,AS协议得到维护和实施.
主要成果:
- 在干预期内,抗生素的使用量,以每1000个患者日的治疗日计算,显著下降 (215比302,p <0.01).
- 早期经验性抗生素的中位持续时间减少了 (基线6天,干预3天,维持2天,p<0.001).
- 对培养负性败血症的抗生素减少了 (22%的基线比11%的干预比6%的维护,p = 0.002),特别是在体重1000-1499克的婴儿中.
结论:
- 在早产VLBW婴儿中,抗菌药物管理是可行的和安全的,从而减少了抗生素的使用.
- 随着时间的推移,AS干预措施,例如缩短未感染婴儿的抗生素疗程,可以持续下去.
- 定期的临床审计和每日的工作人员讨论对于保持AS有效性至关重要.
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