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对社区获得性肺炎患者的药剂师主导的管理建议的接受

Ramara E Walker¹, Rebecca Schulte², Andrea M Pallotta¹

¹Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.

Antimicrobial stewardship & healthcare epidemiology : ASHE

|October 25, 2024

概括

针对社区获得性肺炎 (CAP) 的传染病 (ID) 药剂师管理建议显示,临床医生接受率为72%. 处方者最容易接受IV转换为PO,但对限制抗生素持续时间不那么容易接受.

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
临床药房临床药房

背景情况:

社区获得性肺炎 (CAP) 是美国住院和死亡的重要原因.
过度使用扩展谱抗生素 (ESA) 治疗CAP会加剧抗菌素耐药性.
目前的指导方针主张降低抗生素升级,早期口服切换,以及对CAP的治疗时间限制 (DOT).

研究的目的:

评估临床医生对传染病 (ID) 的接受度,为住院患者提供药剂师主导的管理建议.
评估ID药剂师干预措施对CAP抗生素处方实践的影响.
确定临床医生接受度最高和最低的具体建议领域.

主要方法:

在六个克利夫兰诊所医院进行了一项前性单臂队列研究.
ID药剂师提供了管理建议,以缓解ESA,DOT,IV到PO的过渡,以及停止使用抗菌药物.
描述性统计数据被用来分析临床医生对这些建议的接受率.

主要成果:

药剂师在685次患者接触中提出了959条建议,涉及327名临床医生.
总体而言,临床医生对管理建议的接受率为72%.
接受率因推类型而异:IV到PO过渡 (80%),ESA降级 (78%),抗菌药物停止 (73%) 和DOT (65%).

结论:

临床医生对CAP的ID药剂师领导的管理干预措施表现出普遍的接受性.
处方者最有可能接受静脉注射到口服转换的建议,最不可能接受限制抗生素DOT的建议.
这些发现支持将ID药剂师纳入抗菌药物管理计划,以优化CAP管理.

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