在初级保健中为抗生素处方进行审计和反干预:系统性审查和元分析
Alice X T Xu1,2, Kevin Brown1,2, Kevin L Schwartz1,2,3
1Public Health Ontario, Toronto, Ontario, Canada.
审计和反 (A&F) 干预措施显著减少了初级保健中的抗生素处方. 这一系统性审查发现,A&F与总体体积的减少,不必要的启动,长时间使用和广泛的抗生素使用有关.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗生素耐药性是一个日益增长的全球健康威胁.
- 在初级保健中不适当的抗生素处方有助于抗药性.
- 审计和反 (A&F) 是一种改善处方实践的策略.
研究的目的:
- 系统地审查A&F干预措施对初级保健中抗生素处方的有效性.
- 确定影响A&F干预有效性的变化因素.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,直到2024年5月.
- 提取的试验,参与者和干预特征.
- 对关键处方结果进行随机效应元分析.
主要成果:
- 在分析中包括56个RCT.
- 与显著减少相关的A&F:总体量11%,不必要的启动23%,长时间13%,广谱选择17%.
- 在研究中观察到实质性的异质性.
结论:
- 在初级保健中,A&F干预措施有效地减少了抗生素处方.
- 挑战包括显著的异质性,非标准化的结果定义,以及对干预忠实性的不一致评估.
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