在接受OPAT或COpAT的患者中,抗菌素诱导的中性症:一项大型多站点追溯队列研究
Megan Edwards1, Amy Van Abel1, Omar Abu Saleh2
1Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
在3.8%的患者中,复杂的门诊抗菌药物治疗诱导的中性缺血症 (COIN) 发生,通常与piperacillin/tazobactam有关. 临床药剂师的早期干预在大多数情况下导致了中性粒细胞的恢复.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 有限的数据存在于复杂的门诊抗菌药物治疗诱导的中性质减退症 (COIN) 的发生率,发病和管理.
- 之前没有报道过药剂师参与COIN管理.
- 这项研究通过在学术医疗中心详细介绍COIN来解决这些知识差距.
研究的目的:
- 为了确定COIN的发生率,发病和管理.
- 调查药剂师参与COIN案件的作用和影响.
- 为了确定与COIN相关的特定抗菌剂.
主要方法:
- 一项针对接受抗微生物治疗的成年患者的多站点回顾性队列研究.
- 排除接受化疗或免疫抑制剂的患者.
- 数据收集包括抗微生物疗法,实验室值,干预类型和结果;后勤回归分析了风险因素.
主要成果:
- 从4261次治疗中确定了161例COIN病例 (3.8%的发病率).
- 皮佩拉西林/塔扎巴克坦与更高的COIN几率 (OR1.86) 有显著的关联,而埃尔塔佩内姆则显示出更低的几率 (OR0.43).
- 中性质疏松症诊断的中位时间为22天;66.5%的病例接受了干预,其中96.9%的中性质细胞恢复,通常由药剂师 (74.8%) 发起.
结论:
- 通过实验室监测的多学科审查,可以识别和管理COIN.
- 大多数患者可以在及时干预的情况下安全地完成抗微生物治疗.
- 临床药剂师在启动COIN的干预中发挥着至关重要的作用.
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