描述抗生素疗程修改行为,患者特征和患有格兰阴性细菌感染的患者的结果,一项回顾性单中心研究
Jason Yamaki1,2, Mirna Mikhail1, Richard Beuttler1
1Department of Pharmacy Practice, Chapman University School of Pharmacy (CUSP), Irvine, CA 92618, USA.
Antibiotics (Basel, Switzerland)
|April 26, 2024
概括
抗生素治疗方案的修改在急性治疗中很常见,用于对格兰氏阴性感染的急性治疗. 尽管经常发生变化,但在临床结果中没有观察到差异,这突显了早期识别耐药生物体的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 临床药房 临床药房
- 抗微生物药物管理委员会
背景情况:
- 有限的数据存在于急性护理环境中的抗生素治疗方案修改频率.
- 耐扩展光谱类素的格拉姆阴性生物体构成了重大挑战.
- 早期识别和治疗耐药性感染至关重要.
研究的目的:
- 为了确定复杂的格拉姆阴性感染患者抗生素治疗方案修改的频率.
- 分析与修改相关的患者和治疗特征.
- 评估修改对临床结果的影响.
主要方法:
- 在霍格纪念医院 (Hoag Memorial Hospital) 住院的400名患者 (2019年1月 - 2021年3月) 的回顾性研究.
- 纳入标准:复杂的感染,对扩展频谱类素 (AmpC生产者) 耐药或可能耐药的格拉姆阴性生物体.
- 收集有关感染源,生物,修饰细节和临床结果的数据.
主要成果:
- 72%的患者经历了抗生素治疗方案的修改 (每位患者发生1-6次变化).
- 常见的修改原因:缺乏患者反应 (14%),审查了病史 (9%),脱补偿 (7%).
- 主要存在的生物: 伪omonas spp. (38%) 和产生ESBL的生物 (34%).
结论:
- 频繁修改抗生素治疗方案是急性护理中耐药格兰氏阴性感染的标准做法.
- 这些修改与临床结果没有显著差异有关.
- 这些发现强调了对新型抗生素的需求,并改善了对有耐药生物体风险的患者的早期检测.
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