心脏器械手术中的抗菌管理:行为改变干预对扩展预防实践的影响
Li Wen Loo1, Yvonne Peijun Zhou1, Yi Bo Wang1
1Division of Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Antibiotics (Basel, Switzerland)
|August 28, 2025
概括
实施多方面的抗菌管理计划显著减少了心脏器件植入后的抗生素预防. 这种方法安全地降低了抗生素的使用,而没有增加手术部位的感染.
科学领域:
- 心脏病学
- 传染性疾病
- 医疗服务研究
背景情况:
- 在心脏装置植入后,尽管推单剂量预防,但延长抗生素预防是常见的.
- 在本地,50-60%的患者在插入起器或更换发电机后接受了延长的预防治疗.
- 抗生素管理计划 (ASP) 旨在优化抗生素的使用.
研究的目的:
- 评估多方干预组合与行为改变策略的有效性和安全性,以减少延长的抗生素预防.
- 为解决心脏器件植入后延长预防的高局部率.
主要方法:
- 一个单一中心的追溯队列研究,对21岁以上的患者进行了无并发的心脏起器插入或发电机更换.
- 干预措施包括数据驱动的反,有针对性的教育,ASP冠军参与和临床途径修订.
- 在2022年10月至2025年3月期间对779名患者进行了评估.
主要成果:
- 在ASP干预后,扩展预防的使用率显著下降,从43. 8%降至24. 0% (p < 0. 01).
- 在这两组中,手术部位感染的发生率仍然很低且相似 (0. 8%),所有感染都是表面的.
- 接受任何抗生素的患者总比例从20. 7%降至16. 3% (p < 0. 01).
结论:
- 在心脏器件植入后有效和安全地减少了扩展预防的ASP干预措施.
- 在影响处方行为方面, ASP 冠军的参与至关重要.
- 行为变化干预对于持续的抗菌管理成功至关重要.
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