在高等保健教学医院的抗生素处方实践:回顾性横截面分析
Usman Zafar1,2, Ashir Iqbal3, Abdul Basit4
1Department of Medicine, Dr. Akbar Niazi Teaching Hospital, Islamabad, PAK.
Cureus
|November 11, 2024
概括
在巴基斯坦一家医院发现了高比例的不适当的抗生素处方,没有感染或培养敏感性测试的证据. 这有助于抗菌素耐药性,并迫切需要实施抗生素管理计划.
科学领域:
- 临床药房 临床药房
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 在医院中过度使用抗生素导致抗菌素耐药性 (AMR),这是一个严重的全球健康威胁.
- 巴基斯坦面临着令人担忧的AMR水平,原因是多种和广泛的耐药细菌.
- 不适当的抗生素处方做法普遍存在,需要进行评估.
研究的目的:
- 评估巴基斯坦一家三级医院的抗生素处方做法.
- 通过培养敏感性 (CS) 测试来评估抗生素治疗的适当性.
- 确定抗生素使用模式和患者结果之间的关联.
主要方法:
- 从2020-2022年对1012名住院病人的病历进行了横截面回顾性研究.
- 基于感染证据 (EOI) 和CS测试的抗生素处方分析.
- 统计分析包括后勤回归和Cox比例危险回归.
主要成果:
- 91.8%的患者接受了抗生素治疗;30%的患者缺乏记录的EoI.
- 只有17.5%的患者接受了CS测试.
- 增加抗生素暴露与更高的ICU死亡率和更长时间住院相关.
结论:
- 观察到高比例的非理性抗生素处方没有充分的理由或测试.
- 紧急实施全面的抗生素管理计划 (ASP) 具有强制性CS测试至关重要.
- 通过ASP优化抗生素使用可以减轻AMR并改善患者的治疗结果,特别是在资源有限的环境中.
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