影响初级保健中无并发性尿路感染抗生素适宜性的因素
Li Yan Ng1, Lay Hoon Goh2,3, Stephanie C C van der Lubbe2,3
1National University Polyclinics, National University Health System, Singapore, 609606, Singapore. li_yan_ng@nuhs.edu.sg.
在新加坡,超过一半的无并发性尿路感染 (UTI) 抗生素处方是不适当的. 抗生素过敏和多种症状等因素增加了不适当的处方,突出了需要更好的抗生素管理的需要.
科学领域:
- 传染性疾病 传染性疾病
- 初级医疗保健医学 一级医疗保健医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 尿路感染 (UTI) 是一种常见的初级保健诊断.
- 在尿路感染中不适当使用抗生素有助于治疗失败和抗菌素耐药性.
- 之前没有研究评估了新加坡尿路感染的抗生素适用性.
研究的目的:
- 评估新加坡无并发性尿道感染 (UTI) 的抗生素适宜性.
- 确定与不适当的抗生素处方UTI相关的因素.
主要方法:
- 从2023年1月到6月对369个UTI进行了回顾性观察研究.
- 从新加坡的7家初级保健诊所收集的数据,使用点流行调查方法.
- 二变量分析和多变量逻辑回归用于识别影响因素.
主要成果:
- 53.4%的UTI抗生素处方被认为是不合适的.
- 阿莫西西林/克拉夫兰酸是最常被处方的抗生素 (47.2%).
- 不适当的处方与抗生素药物过敏 (OR 2.49) 和多病患者投诉 (OR 1.32) 有关. 访问的诊所也显著影响了适当性 (p=0.004).
结论:
- 在新加坡的初级保健中,存在大量不适当的抗生素处方UTI.
- 患者因素 (过敏,多种症状) 和临床变化会影响处方的适当性.
- 需要有针对性的干预措施,包括决策支持和教育,以加强抗生素管理.
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