在农村卫生系统中治疗无症状细菌性尿症的风险因素
Miranda Rang1, Rana Nasser2, Rachel Gabor3
1Clinical Pharmacy, Marshfield Clinic Health System, Marshfield, WI, USA.
概括
尽管有指导方针,在农村医院治疗无症状细菌性尿症的高率仍然存在. 诸如疲劳和心智变化等非特异性症状,以及阳性亚酸盐和皮尤里亚,影响了治疗决策.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 无症状细菌尿 (ASB) 在住院患者中很常见.
- 不适当治疗ASB有助于抗菌素耐药性和不良事件.
- 目前的指导方针建议大多数情况下不要治疗ASB.
研究的目的:
- 确定威斯康星州农村卫生系统中ASB的治疗率.
- 确定影响临床医生决定治疗ASB的患者特定因素.
- 为了告知抗微生物管理干预措施.
主要方法:
- 在2022年1月至5月的ASB住院成年人的回顾性描述性研究.
- 纳入标准:住院患有ASB的成年人;排除标准:尿路异常,活跃感染,尿路感染症状,最近的泌尿外科手术,免疫妥协或转移.
- 通过电子和手动图表抽象收集的数据.
主要成果:
- 从429个阳性尿液培养中,包括137名ASB患者.
- ASB治疗率为78.1%,导致393天不必要的抗微生物治疗.
- 与治疗相关的因素包括疲劳 (P=0.014),心智变化 (P<0.006),阳性亚酸盐 (P=0.026),以及皮尤里亚 (P<0.001).
结论:
- 与指导方针相反,农村住院患者的ASB治疗率仍然很高.
- 非特异性症状 (疲劳,思维变化) 和实验室发现 (亚酸盐,腹) 与治疗决定有关.
- 未来的管理工作应该解决这些因素在ASB管理中的低特异性.
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