与患者相关的因素影响了住院抗生素过敏脱标的实施
Susan Herrmann1, Rishabh Kulkarni1,2, Michelle Trevenen3
1School of Medicine, The University of Western Australia, Perth, Australia.
抗生素过敏的取消标签在医院中是复杂的. 虽然对一些人来说是可行的,但竞争性临床问题和患者接受等障碍存在,这表明针对年轻患者具有高抗生素需求的针对性方法.
科学领域:
- 临床医学 临床医学
- 过敏和免疫学 过敏和免疫学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 抗生素过敏标签带有显著的负面临床后果,影响医疗保健和患者的结果.
- 评估医院住院患者的抗生素过敏标签 (AAL) 对于改善护理至关重要.
- 一项随机对照试验旨在评估住院患者的AAL评估.
研究的目的:
- 确定建立成人抗生素过敏脱标服务的可行性.
- 评估住院抗生素过敏脱标服务的潜在好处和障碍.
- 识别可能从取消标签干预中受益最多的患者子组.
主要方法:
- 一个随机对照试验,涉及1503名住院患者,现有AAL.
- 查符合AAL评估的资格,排除标准包括禁用药物使用和认知障碍.
- 随机选择符合条件的患者进行皮肤测试±口服挑战,直接口服挑战或通常的护理,随访5年.
主要成果:
- 只有28.5%的AAL住院患者有资格进行评估.
- 老年患者不太可能有资格,而手术患者更有可能.
- 39名患者被随机分配,其中20人接受过敏测试,19人接受常规护理.
结论:
- 由于竞争的临床问题和患者接受,急性护理中的抗生素过敏脱标提出了挑战.
- 住院脱标服务可能不会普遍节省成本,但特定的患者群体可能会受益.
- 针对年轻患者和预测高抗生素使用率的患者提供最大的个人和卫生系统益处.
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