在南非多学科重症监护病房中,持续或间歇性注射β-乳糖抗生素:随机对照试验
Ayesha Bibi Khan1, Mohd Hafiz Abdul-Aziz2, Lucy Hindle1
1Division of Critical Care, University of Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
The Journal of infection
|April 16, 2025
概括
连续输注 (CI) 的β-乳糖抗生素没有显示优越性超过间歇性玻尿酸 (IB) 临床治愈在重症败血症患者. 这项研究发现,这两种施用方法在14日临床治愈率上没有显著差异.
科学领域:
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 贝塔乳酸抗生素表现出时间依赖的杀菌活性.
- 连续输注 (CI) 可以优化抗生素度与间歇性注射 (IB) 相比.
研究的目的:
- 为了评估β-乳CI是否改善南非多学科重症监护病房 (ICU) 的14日临床治愈率与IB相比.
主要方法:
- 成年败血症患者通过24小时CI或IB接受了阿莫西西林 - 克拉夫兰酸盐,皮佩拉西林 - 塔扎巴克坦,伊米佩内姆 - 基拉斯塔丁或美罗佩内姆.
- 排除标准包括先前使用抗生素超过24小时,怀孕或替代疗法.
- 主要结局是临床治愈 (在48小时内没有重新开始,在第14天完成抗生素治疗).
主要成果:
- 纳入了122名具有平衡基线特征的患者.
- 临床治愈率为CI的81%,而IB的74.1% (p=0.345).
- 90日死亡的相对风险为0.57 (95% CI 0.32-1.01) 的CI与IB相比.
结论:
- 这项研究没有证明持续输液β-乳糖抗生素与间歇性玻尿酸相比,对于在重症败血症患者中实现临床治愈的优越性.
- 在CI和IB组之间,没有观察到临床治愈率或ICU停留时间的显著差异.
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