通过评估提供者关于尿路感染症状的文档来确定治疗的适当性
Geneva M Wilson1, Ravyn Jackson2, Sara Abdelrahim3
1Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Hines, IL; Department of Preventive Medicine, Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL.
American journal of infection control
|July 17, 2025
概括
许多对无症状细菌尿症 (ASB) 的门诊抗生素处方是不合适的,通常是由于实验室结果而不是患者症状. 这凸显了对更好的诊断实践和抗微生物药物管理的需要,以打击耐药性.
科学领域:
- 传染性疾病 传染性疾病
- 临床药房 临床药房
- 抗微生物药物管理委员会
背景情况:
- 无症状细菌性尿病 (ASB) 涉及一个没有症状的阳性尿液培养.
- 通常不建议治疗ASB,因为它是无效的,并促进抗菌素耐药性.
研究的目的:
- 确定退伍军人事务部门诊所中对ASB的不适当抗生素处方的流行情况.
- 确定导致不适当的ASB处方的因素.
主要方法:
- 对484名患者访问的回顾性队列研究,其中尿液培养呈阳性 (2019-2022年).
- 根据尿路感染症状的存在分类的访问:尿路感染存在,尿路感染不太可能,尿路感染缺席.
- 对于非UTI访问,评估了提供者推理和抗生素处方的时间.
主要成果:
- 超过一半的访问被归类为无尿路感染或无尿路感染的访问接受了抗生素处方.
- 这些处方中很大一部分与尿液分析或尿液培养结果的阳性直接相关.
- 不适当的处方也与延迟或访问前处方有关.
结论:
- 在门诊环境中对ASB进行不适当的抗生素处方通常是对实验室发现的反应.
- 加强诊断策略和强大的抗菌药物管理计划对于ASB管理至关重要.
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