处方万科米辛囊与排出液体对C. difficile感染再入院的影响
Rachel Reise1, Silken A Usmani1, Earl Morris2
1University of Florida College of Pharmacy, Gainesville, FL, and University of Florida Health Physicians, Gainesville, FL, USA.
概括
在Clostridioides difficile感染 (CDI) 治疗中,医院的成本节约措施取代了液体万科米辛的囊,这并没有增加30天的再入院,但与60天的再入院率更高有关. 进一步调查释放处方做法是有必要的.
科学领域:
- 传染性疾病 传染性疾病
- 医院药房实践 医院药房实践
- 药物经济学 药物经济学
背景情况:
- 艰难菌感染 (CDI) 是一个重要的医院获得的感染.
- 口服万科米是一种常见的治疗CDI.
- 降低成本的举措可能包括将复合液体万科米辛替代囊.
研究的目的:
- 评估处方万科米辛液体与囊在出院时对CDI患者再入院率的影响.
- 评估成本节约措施是否会影响患者的治疗结果.
主要方法:
- 在6年内使用学术医院的电子健康记录进行了回顾性队列研究.
- 与30天,60天和90天所有原因和CDI特定再入院率进行比较.
- 使用了考克斯的比例危险和波松回归模型,并对图表进行审查以确认再接收.
主要成果:
- 在440名患者中,68%的患者接受了万科米辛液体,32%的患者接受了囊.
- 液体和囊组之间的30天所有原因或CDI特定再入院没有显著差异.
- 处方液体万科米辛的患者在60天所有原因 (1.87) 和CDI特定 (2.84) 再入院时显示出更高的调整后危险比率.
结论:
- 医院政策将液体万科米辛替代囊可能会对再接收率产生负面影响.
- 节省成本的药房实践需要仔细评估对患者结果的潜在意外后果.
- 该研究强调需要监测处方模式和在表单变化后的患者再接收情况.
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