在综合医疗保健系统中对出院后的抗生素使用进行全面评估
Daniel J Livorsi1,2, Matthew Bidwell Goetz3,4, Bruce Alexander1
1Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.
Infection control and hospital epidemiology
|September 17, 2025
概括
医院出院后使用抗生素的很大一部分发生在急性治疗后或通过门诊亲肠道抗生素治疗 (OPAT). 这凸显了对抗生素处方模式的电子监控所面临的挑战.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 在医院出院时对抗生素使用的电子监测具有挑战性,特别是对于无法返回家园的患者.
- 准确跟踪出院后的抗生素管理对于抗菌药物管理和公共卫生监督至关重要.
- 退伍军人卫生管理局 (VHA) 医院管理着大量的患者群体,各种出院途径.
研究的目的:
- 估计在急性病后护理设施或通过门诊亲肠道抗生素治疗 (OPAT) 计划中使用的退院后抗生素的比例.
- 评估电子数据捕获的完整性,以便在放药后使用抗生素.
- 在VHA系统中,为改进抗微生物药物管理和监督的战略提供信息.
主要方法:
- 在2018-2021年期间退院的VHA急症治疗病人的回顾性研究.
- 对退院后抗生素治疗时间的分析,包括电子数据和手动图表审查.
- 包括129家VHA医院的数据.
主要成果:
- 分析了超过190万例入院病例,42.6%接受住院抗生素治疗.
- 32.8%的退院后所有抗生素日发生在急性治疗后或通过OPAT.
- 56.1%的与医院相关的抗生素暴露日被归类为出院后.
结论:
- 大约三分之一的出院后抗生素是在急性治疗后或通过OPAT计划发放的.
- 这些环境中缺少或难以收集的抗生素数据使医院的比较和监测变得复杂.
- 需要改进数据收集方法,以准确评估出院后的抗生素使用及其影响.
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