2012年至2020年晚期早产和满期新生儿抗生素使用的变化:2020年全国基于人口的观察性研究
Johan Gyllensvärd1,2, Marie Studahl3,4, Lars Gustavsson3,4
1Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden johan.gyllensvard@gu.se.
概括
瑞典新生儿的抗生素使用因地区和单位而异,与早期发作的败血症 (EOS) 发病率相比,抗生素使用率不成比例. 这凸显了减少新生儿不必要的抗生素处方的必要性.
科学领域:
- 新生儿护理 新生儿护理
- 传染病流行病学 传染病流行病学
- 药物监督 药物监督 药物监督
背景情况:
- 由于潜在的长期健康影响,新生儿使用抗生素越来越令人担忧.
- 早发性败血症 (EOS) 是新生儿的一种严重感染,需要立即接受抗生素治疗.
- 了解抗生素处方实践中的差异对于优化新生儿护理至关重要.
研究的目的:
- 量化瑞典新生儿抗生素使用的区域和单位水平变化.
- 评估早发性败血症 (EOS) 的发生率和相关死亡率在晚期早产和满期新生儿中.
- 检查抗生素处方模式与EOS发病率之间的关系.
主要方法:
- 全国范围的队列研究利用瑞典新生儿质量登记册的数据.
- 包括所有在2012年至2020年期间被录取到新生儿病房的晚期早产和满期新生儿 (妊娠≥34周).
- 分析不同地区和单位的抗生素使用,EOS发病率和死亡率.
主要成果:
- 包括100多万名新生儿;1.9%接受抗生素,不同地区和单位的变化为2到5倍.
- 平均抗生素持续时间有所不同,EOS婴儿的疗程较长 (7-10天),与没有 (4-7天) 的婴儿相比.
- 每1000个活产婴儿中,EOS的发病率在0.33到0.93之间;每例EOS治疗婴儿的数量差异很大 (22-39个区域,7-113个单位).
结论:
- 在瑞典,每例EOS病例的抗生素使用和治疗的区域和单位水平存在显著差异. 在瑞典,每例EOS病例的抗生素使用和治疗的区域和单位水平存在显著差异.
- 抗生素的处方似乎与EOS的实际发病率不成比例,这表明潜在的过度使用.
- 需要尽量减少新生儿护理中不必要的抗生素使用,以改善结果并减少耐药性.
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