对瘤病房进行面对面的前性审计和反:制定一个免疫功能受损的抗微生物药物管理计划
Hannah Imlay1, Sage B Greenlee2,3, Brandon J Tritle2
1Division of Infectious Diseases, Department of Internal Medicine, University of Utah Health, Salt Lake City, UT, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|October 21, 2024
概括
抗菌药物管理计划可以优化癌症患者的抗生素使用. 面对面的前性审计和反干预导致了高接受率和减少了瘤服务中的抗菌药物管理.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
背景情况:
- 在免疫功能低下的患者,特别是癌症患者中使用抗菌剂需要谨慎管理,以防止耐药性和改善结果.
- 面对面的前性审计和反 (IPPAF) 是一种优化抗菌药物处方的策略.
- 由于复杂的患者群体和频繁的感染,瘤学服务对抗微生物药物管理提出了独特的挑战.
研究的目的:
- 描述临床综合征,确定抗微生物药物优化机会,并评估在使用IPPAF在住院瘤服务上的免疫功能受损抗微生物药物管理计划内接受建议.
- 评估IPPAF对瘤科单位抗微生物药物给药率 (SAAR) 的影响.
主要方法:
- 一项回顾性队列研究对一个学术癌症中心的三个住院瘤服务进行了回顾性队列研究.
- 干预措施被前性地记录,包括临床综合征,提出的建议和接受率.
- 在IPPAF实施之前和之后,分析了瘤学单位的标准化抗微生物药物管理比率 (SAAR).
主要成果:
- 在34周内,对138名患者进行了154次干预,转移性恶性瘤是常见的 (52%) 和高90天死亡率 (43%).
- 常见的综合征包括诊断不确定性 (21%),腹内病理 (19%),肺炎 (16%),尿路感染 (8%).
- 建议侧重于治疗时间的变化 (41%) 和停止非传染性综合征 (19%),总体接受率为77%. 几个SAAR在IPPAF后出现下降.
结论:
- 在患有固体瘤恶性瘤的患者中,存在显著的抗微生物优化机会.
- 虽然许多综合症与非瘤学人群重叠,但独特的病例需要针对抗菌药物管理的有针对性的教育举措.
- IPPAF是改善抗微生物药物处方和减少在住院瘤诊所使用的有效策略.
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