法国儿科重症监护室遵守抗生素治疗指南:一项多中心观察性研究
Romain Amadieu1, Camille Brehin2,3, Adéla Chahine4
1Neonatal and Paediatric Intensive Care Unit, Children's Hospital, Toulouse University Hospital, 330 Avenue de Grande Bretagne, TSA 70034, Toulouse Cedex 9, 31059, France. amadieu.r@chu-toulouse.fr.
BMC infectious diseases
|June 12, 2024
概括
超过一半的细菌感染 (BIs) 的儿科重症监护病房患者没有接受符合抗生素治疗. 通过使用协议和日常抗菌药物管理计划 (ASP),可以改善对抗菌药物指南的遵守.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染性疾病 传染性疾病
- 抗微生物药物管理管理
背景情况:
- 细菌感染 (BI) 是儿科重症监护室 (ICU) 的一个重大问题.
- 评估是否遵守抗生素建议,并识别不遵守因素对于有效治疗至关重要.
研究的目的:
- 评估在儿科和新生儿ICU中遵守抗生素指南.
- 确定与细菌感染抗生素治疗不遵守相关的因素.
主要方法:
- 在法国八个儿科和新生儿重症监护室进行了观察性研究.
- 在一年内分析了134名儿童的139次疑似或已被证明的BI.
- 排除标准包括新生儿<72小时,新生儿<37周,年龄≥18岁,以及手术预防.
主要成果:
- 51.1%的抗生素处方不符合建议.
- 不适当的抗菌药物选择,治疗持续时间和持续时间是违规的主要原因.
- 与不遵守相关的因素包括处方多种抗生素,长时间的宽频疗法,神经学妥协,疑似导管相关的细菌病,多器官功能障碍的败血症和晚期发作的VAP.
结论:
- 在ICU中,一半的抗生素处方不符合指南建议.
- 建议每天重新评估抗生素的使用,包括降低和停止使用.
- 制定治疗共识,利用部门协议,并实施日常抗菌药物管理计划 (ASP) 可以提高合规性.
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