在重症监护室的抗微生物降级的一个基于代理的模型:对临床试验设计的影响
1Department of Mathematics, University of Miami, Coral Gables, FL, United States of Ameica.
抗微生物降级,减少抗生素谱,可以降低耐药性Pseudomonas aeruginosa感染. 然而,临床试验需要更大,更长的时间来证实这些好处.
科学领域:
- 传染性疾病 传染性疾病
- 计算生物学 计算生物学
- 临床微生物学 临床微生物学
背景情况:
- 建议进行抗微生物降级,以减少广泛抗生素的使用,并预防耐药性.
- 在临床研究中观察到的降级的生态益处是不一致的.
- Pseudomonas aeruginosa 是在医院获得的感染的常见原因.
研究的目的:
- 评估抗微生物降级对抗生素耐药性的生态影响.
- 估计评估降级的临床试验所需的样本大小和研究持续时间.
- 解释以前临床研究中关于降级的发现中的差异.
主要方法:
- 使用计算机模拟来建模降级对抗性流行影响.
- 从模型中生成合成数据,以告知临床试验设计.
- 分析的重点是 Pseudomonas aeruginosa 对实证抗生素的耐药性.
主要成果:
- 降级可以减少殖民和由耐药菌株感染,并限制广谱抗生素的使用.
- 这一策略可能会减少超级感染的发生率,特别是在遵守良好的手部卫生方面.
- 观察降级的影响需要至少有十个臂和四年持续时间的研究.
结论:
- 数学建模可以澄清关于抗微生物降级的有争议的发现.
- 降级显示了减少耐药细菌菌株的潜在生态益处.
- 未来的临床试验必须显著更大,更长的时间来验证降级的影响.
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