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一个试点干预试验,以减少在常见的内分泌外科手术后使用手术后的抗微生物药物的使用

Daniel J Livorsi^1,2, Vignesh T Packiam³, Qianyi Shi^1,2

¹Iowa City Veterans' Administration Health Care System, Iowa City, IA, USA.

Infection control and hospital epidemiology

|November 7, 2024

概括

一个捆绑的干预措施减少了三个地点之一的泌尿外科手术后不必要的抗菌药物使用. 这种方法证明了安全性,没有增加并发症,突出了指导方针实施的挑战.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
传染性疾病传染性疾病
改善医疗保健质量改善医疗保健质量

背景情况:

术后的抗微生物预防经常被规定,尽管专业指南不建议.
过度使用抗菌素有助于抗菌素耐药性和医疗保健成本.

研究的目的:

为了减少在常见的内镜泌尿外科手术后使用术后抗微生物药物的使用.
评估旨在优化抗微生物药物处方实践的捆绑干预措施的有效性.

主要方法:

在三个医疗中心进行了准实验性的前后试验.
干预包括教育,当地冠军,以及对抗菌素处方的审计和反.
收集了关于抗微生物药物的使用和尿道透视和膀瘤或前列腺手术后的顺尿管切除后的非计划性访问的数据.

主要成果:

总体而言,手术后过度使用抗菌素的比例从基线时的50.6%下降到干预期间的41.1%.
在三个地点之一观察到抗菌素处方的显著减少 (几率比0.09).
在所有地点都没有注意到程序后意外访问或并发症的显著增加.

结论:

捆绑干预可以减少在泌尿外科手术中术后的抗微生物药物的使用,尽管有效性可能因地点而异.
干预是安全的,没有观察到并发症的增加,支持遵循指南.
实施基于指导方针的抗微生物预防具有挑战性,但可以实现和安全.

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