肝脏与静脉注射抗生素对重症患者:一个试点研究
Dayana Dos Santos Oliveira1, Julia Vitória da Rocha2, Juliano Gasparetto3
1Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Curitiba, PR, Brazil.
概括
肠道抗生素 (EN) 对重症患者是安全有效的,与静脉注射 (IV) 抗生素相比,其在生存或临床结果上没有差异. 这种方法显著降低了重症监护室 (ICU) 的药物成本.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 临床药房 临床药房
背景情况:
- 在重症监护病房 (ICU) 中存在关于肠道抗生素 (EN) 的担忧.
- 之前的研究还没有彻底评估反对使用EN的证据.
- 这项研究解决了在重症监护中基于证据评估EN的需要.
研究的目的:
- 评估在重症患者中从静脉注射 (IV) 过渡到肠道抗生素 (EN) 的情况.
- 为了比较EN与IV抗生素治疗的疗效和安全性.
- 评估EN对临床结果,成本和ICU资源利用的影响.
主要方法:
- 未来的,多中心的,随机的,没有盲目的临床试验.
- 涉及的病情危急的感染患者接受抗生素治疗.
- 将顺序IV抗生素与EN疗法进行比较,主要结局是死亡率和临床改善.
主要成果:
- 在EN和IV组之间,医院内死亡率或临床结果没有显著差异.
- 相似的安全性概况,只有10.5%的EN患者需要恢复IV治疗.
- 肠道抗生素显著降低了药物成本 (IV组增加了207%).
结论:
- 这是第一个关于在ICU内口服/肠道抗生素的随机对照研究.
- 肠道抗生素是一种安全有效的替代IV治疗在重症患者.
- 抗生素在降低成本的情况下提供可比的临床结果和生存率.
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