抗生素使用模式和与怀疑二次感染的COVID-19患者白细胞减少相关的因素:印尼的一项横截面研究
Pricella A Ginting1, Tjokorde Ia Padmasawitri1, Nadia Hanum1
1Department of Pharmacology-Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung, Indonesia.
Narra J
|May 12, 2025
概括
针对COVID-19患者的抗生素处方通常涉及多种药物,而没有确定的细菌感染,这引发了抗生素耐药性的担忧. 这项研究发现,使用的抗生素数量与白细胞计数正常化等临床结果之间没有联系.
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.
- 公共卫生 公共卫生
背景情况:
- 在COVID-19患者中过度使用抗生素是一个重大问题,导致抗菌素耐药性.
- 在COVID-19中,二次细菌感染需要谨慎的抗生素管理,以避免耐药性和改善结果.
- 了解当前的抗生素处方模式对于开发有针对性的干预措施至关重要.
研究的目的:
- 分析怀疑二次感染的住院COVID-19患者的抗生素处方模式.
- 评估抗生素使用与临床结果之间的关联,重点关注白细胞计数.
- 在这个患者队列中识别经常处方的抗生素和相关的病原体.
主要方法:
- 对376名住院COVID-19患者 (≥17岁) 具有高白细胞计数的回顾性分析.
- 使用的解剖治疗化学/定义的每日剂量 (ATC/DDD) 和药物利用率 (DU) 90%的模式评估方法.
- 收集的人口,临床,培养数据和抗生素治疗信息.
主要成果:
- 大多数患者接受多种抗生素 (> 2),与与年龄,细菌病原体,住院时间和结核病相关的模式.
- 常见的病原体包括 *金黄色葡萄球菌*, *S.haemolyticus*, *Klebsiella肺炎*, *Acinetobacter baumannii* 和 *Escherichia coli*.
- 最常见的药物是阿兹特罗米辛,莱沃富洛克萨辛和塞夫特里亚克松;在抗生素量和白细胞正常化之间没有发现显著的关联.
结论:
- 广泛的抗生素,特别是来自WHO AWaRe"观察"类别的抗生素,是普遍存在的.
- 虽然抗生素选择考虑了病原体类型和并发性疾病,但标准化指南对于优化使用至关重要,特别是在病原体测试有限的地方.
- 在COVID-19中解决不适当的抗生素使用对于打击抗菌素耐药性至关重要.
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