监管促使改善肺炎抗生素选择:INSPIRE随机临床试验
Shruti K Gohil1, Edward Septimus2, Ken Kleinman3
1Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine.
计算机化提供者订单输入 (CPOE) 促使肺炎患者的扩展谱抗生素使用显著减少. 这一策略改善了抗生素管理,但没有影响患者的安全结果,如重症监护室转移或住院.
科学领域:
- 传染性疾病
- 医院管理
- 临床信息学
背景情况:
- 肺炎是住院的主要原因,
- 临床不确定性关于多药耐药生物 (MDRO) 感染风险往往导致经验性抗生素升级.
- 需要优化肺炎患者抗生素选择的策略, 以制过度使用.
研究的目的:
- 评估计算机化提供者订单输入 (CPOE) 提示是否可以减少非危急性肺炎患者的经验性扩展谱抗生素使用.
- 评估MDRO风险估计在CPOE中对抗生素处方实践的影响.
主要方法:
- 在18个月的基线和15个月的干预期内参与59家美国社区医院的集群随机试验.
- 干预组获得了CPOE管理包:教育,反和实时MDRO基于风险的CPOE提示.
- 对照组接受了常规的管理实践;主要结果是经验性扩展谱抗生素治疗日.
主要成果:
- 使用CPOE提示的医院显示经验扩展谱抗生素治疗日减少了28.4% (率比,0.72;P<.001).
- 没有观察到安全结果的显著差异,包括转移到ICU的几天和住院时间.
- 这项研究包括96,451名患有肺炎的成年患者.
结论:
- 将CPOE提示与MDRO风险估计相结合,可以有效地减少肺炎的经验性扩展谱抗生素使用.
- 这种干预表明了抗生素管理的成功方法,而不会影响患者的安全.
- 这些发现支持在医院环境中更广泛地采用基于CPOE的决策支持工具.
更多相关视频
03:22Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE
Published on: March 1, 2024
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
相关概念视频
Antibiotic Selection
Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Pneumonia III: Complications and Assessment
Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
