碳烯预授权的长期影响:20年间的中断时间序列研究
1Division of Infectious Disease and Hospital Epidemiology, Saga University Hospital, Saga, Japan.
The Journal of hospital infection
|June 26, 2025
概括
在过去的20年里,碳烯的预先授权有效地减少了过度使用. 这一策略被证明是安全的,没有对医院流行病学或死亡率产生不利影响.
科学领域:
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
- 抗微生物药物管理委员会
背景情况:
- 过度使用卡巴是医疗保健机构的一个重大问题.
- 关于碳烯限制策略有效性的长期数据有限.
研究的目的:
- 通过事先授权评估碳烯限制的长期影响.
- 评估近二十年来对抗微生物药物使用密度 (AUD),死亡率和抗生素耐药性的影响.
主要方法:
- 间断时间序列 (ITS) 分析,比较干预前 (2004-2005) 和干预 (2006-2023) 期间.
- 检查了卡巴胺AUD,28天内死于医院细菌病的死亡率,以及耐药病原体的流行率.
主要成果:
- 预审后卡巴胺AUD显著减少 (水平变化P=0.002,趋势转变P=0.048).
- 由于医院内细菌病的28天死亡率没有增加.
- 在卡巴胺AUD和MRSA,抗美罗胺P.aeruginosa和A.baumannii的流行率之间发现了积极的相关性.
结论:
- 长期的碳烯预授权有效地减少了抗微生物药物的使用.
- 该战略在20年内没有对医院流行病学产生不利影响.
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