限制美罗胺供应的影响:一个多中心的回顾性研究
Yoshimichi Koutake1, Yoji Nagasaki2, Ryosuke Hirata1
1Department of Pharmacy, Clinical Research Institute, NHO Kyushu Medical Center, 1-8-1 Jigyouhama, Chuo-ku, Fukuoka 810-8563, Japan.
概括
日本的美罗烯 (MEPM) 限制导致了卡巴烯的使用减少和广泛抗生素的增加,使患者的治疗结果恶化. 这凸显了碳烯在治疗严重感染中的关键作用,特别是在药物短缺期间.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 从2022年8月到2023年3月,一种仿制美罗 (MEPM) 产品在日本面临供应限制.
- 这项研究调查了这种美罗胺缺乏的后果.
研究的目的:
- 评估美罗 (MEPM) 限制对抗微生物药物使用模式的影响.
- 评估MEPM供应中断后的细菌病死亡率和耐药细菌的流行情况的变化.
主要方法:
- 在五个机构进行了一项多中心的回顾性研究.
- 对抗微生物药物的使用,细菌性死亡率和耐药细菌在对照期 (限制前) 和MEPM供应限制期之间进行了比较.
主要成果:
- 卡巴胺治疗日数 (DOT) 在所有机构都下降,而第四代头素和 piperacillin/tazobactam DOT 增加.
- 限制供应MEPM期间与显著更高的30天和90天死亡率和更短的生存时间有关.
- 梅罗胺供应限制,晚年,高皮特细菌病评分,低血小板计数,低专蛋白水平和MRSA血流感染是30天死亡率的独立风险因素.
- 在两个时期之间没有观察到抗卡巴因的Pseudomonas aeruginosa和Enterobacteriaceae检测率的显著差异.
结论:
- 梅罗胺 (MEPM) 限制减少了卡巴胺的使用,增加了对其他广谱药物的依赖,并对细菌病预后产生了负面影响.
- 碳烯对于治疗严重感染至关重要,并且在意外的供应中断时很难替代.
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