儿科抗菌药物管理计划对血液源性骨关节感染的影响
Aina Font1,2, Marta Agüera3,4, María Ríos-Barnés5
1Pharmacy Department, Consorci Hospitalari de Vic, Vic, Spain.
European journal of pediatrics
|June 17, 2025
概括
实施抗菌药物管理计划 (ASP) 安全地减少了患有骨和关节感染的儿童的抗生素治疗时间和住院时间. 此外,ASP还降低了第三代头素的使用,但并没有增加不良事件.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物药物管理管理
- 医院质量改善 医院质量改善
背景情况:
- 抗生素管理计划 (ASP) 优化了抗生素的使用和降低了耐药性,只有有限的儿科数据.
- 传统上,长时间的IV抗生素用于儿科骨关节感染,但较短的疗程是有效的.
研究的目的:
- 评估基于医院的ASP对治疗儿童急性血源性骨关节感染 (AH-BJI) 的影响.
- 评估ASP实施后抗生素治疗持续时间,住院时间和特定抗生素使用的变化.
主要方法:
- 一项准实验性研究比较了ASP实施前 (2015-2016) 和之后 (2017-2023) 的儿科患者的AH-BJI治疗.
- 该ASP主要使用处方后审查与反和更新的经验性抗生素协议.
- 结果包括抗生素治疗的长度,住院时间,后果,再入院和死亡率.
主要成果:
- 该研究包括285名患者 (60名ASP前,225名ASP后).
- 在ASP实施后,亲肠道抗生素治疗持续时间 (中位数为7天与8.5天) 和住院时间 (中位数为7天与8.5天) 显著减少 (p<0.001).
- 在2020年6月之后,第三代头素的使用在5岁以下的儿童中显著下降 (10% vs 81%,p<0.001).
结论:
- 实施ASP安全地减少了儿科AH-BJI的亲肠道抗生素持续时间和住院时间.
- 此外,ASP还导致了第三代黄素使用的显著减少.
- 后续病例,再接收和死亡率保持不变,这表明安全实施.
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