从万科米辛改为含有抗生素的皮素的实践改变后的后续效应的比较 含有抗生素的治疗方案用于死角性肠球炎
James Hunter Fly1,2, Kelley R Lee1,2, Sandra R Arnold2,3
1Department of Clinical Pharmacy and Translational Science, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA.
Clinical pediatrics
|August 15, 2024
概括
西林是有效的治疗死性肠球炎 (NEC),即使在高MRSA率. 这种抗生素变化并没有增加急性损伤 (AKI) 或NEC后果等不良结果.
科学领域:
- 新生儿手术 新生儿手术
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
背景情况:
- 死性肠球炎 (NEC) 是早产婴儿的一种严重疾病.
- 针对NEC的抗生素选择至关重要,特别是随着抗菌素耐药性日益增加.
- 耐甲基西林黄金葡萄球菌 (MRSA) 在新生儿重症监护病房中构成了重大挑战.
研究的目的:
- 评估从万科米辛转换为安培素对新冠肺炎管理中的格拉姆阳性覆盖的影响.
- 为了比较抗生素治疗方案之间与NEC相关的继发症和急性损伤 (AKI) 的发生率.
- 在NEC患者中识别继发症和AKI的风险因素.
主要方法:
- 73名NEC患者 (2016-2020年) 的回顾性,单中心队列分析.
- 利用多变量逻辑回归来分析抗生素疗法,后果和AKI之间的关联.
- 机构指导方针变化后的结果进行比较,将万科米辛替换为安皮西林.
主要成果:
- 含氨基素的治疗方案与增加NEC后果或AKI无关.
- 较低的月经后年龄 (<29周) 和血管压缩剂的使用与后果有关.
- 第三阶段的NEC独立地与更高的AKI风险有关.
结论:
- 含氨基素的疗法对NEC管理是有效和安全的,即使在MRSA流行率高的环境中也是如此.
- 早期的月经后年龄和血管压缩剂的支持是NEC后遗症的危险因素.
- 严重的NEC (第三阶段) 是AKI的重要预测因素.
相关概念视频
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
260
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
260
01:22Aneurysm IV: Nursing Management
627
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
627
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
866
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
866
01:25Clinical Significance of Antibiotic Resistance
115
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
115