在住院的退伍军人中使用抗微生物药物的模式,有或没有青素类过敏症
Funnce Liu1, Hang Hoang-Nguyen1, Erin Ham2,3
1Pharmacy Services, VA Puget Sound Health Care System, Seattle, WA, USA.
概括
青素 (PCN) 过敏标签在住院退伍军人中正在减少,不论过敏状况如何,某些抗生素的使用也在增加. 处方差异正在缩小,除了特定的药物类别.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 青素 (PCN) 过敏标签可以导致使用更广泛的抗生素,可能有助于抗菌素耐药性.
- 了解PCN过敏患病率和抗生素处方趋势对于优化退伍军人卫生管理局 (VHA) 的抗生素管理至关重要.
研究的目的:
- 评估VHA在减少青素 (PCN) 过敏标签影响方面的进展.
- 确定住院退伍军人中PCN类过敏的流行率.
- 描述在有PCN类过敏和没有PCN类过敏的情况下住院的抗生素处方模式.
主要方法:
- 一项横截面研究分析了2011年至2022年期间6541299例急性护理住院病人的全国样本.
- 计算了PCN类过敏在入院时的患病率.
- 波松回归比较了PCN类过敏和没有PCN类过敏的住院患者之间的抗生素使用情况.
主要成果:
- 在2011年至2022年期间,PCN类过敏的患病率从12.99%降至11.20%
- 不管PCN类过敏状况如何,使用塞法佐林和非伪的第三代塞法索的比例都增加了.
- 处方差异在某些抗生素类别 (例如,抗MRSA药物,卡巴胺,阿兹特雷诺) 中缩小,但在其他类别 (例如,诺基诺) 中扩大.
结论:
- 青素 (PCN) 过敏的患病率正在下降,在住院的退伍军人中,窄谱β-lactam的使用正在增加.
- PCN过敏和非过敏患者之间的抗生素处方差异正在减少,除了特定的抗生素类别.
- 这些发现突出了针对性干预的领域,以进一步减轻PCN过敏标签对抗生素选择的影响.
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