在需要体外膜氧化的儿科患者中标准化抗菌预防
Jordon C Mitzelfelt1, Roland C Hentz2, Elizabeth H Ristagno3
1From the Division of Pediatric Critical Care, Children's Mercy, Kansas City, Missouri.
The Pediatric infectious disease journal
|September 18, 2025
概括
实施标准化窄谱抗微生物预防方案用于儿科外体膜氧化 (ECMO) 改善了抗微生物处方的适当性. 这一变化并没有增加儿科ECMO患者的医院内感染.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病管理 传染病管理
- 支持体外膜氧化 (ECMO) 的支持.
背景情况:
- 针对儿科外体膜氧化 (ECMO) 患者的抗菌预防指南尚未在国际或国家标准化.
- 缺乏明确的指导方针导致在这个脆弱人群中不一致地使用抗微生物药物.
研究的目的:
- 分析实施狭窄光谱ECMO抗微生物预防方案的影响.
- 根据ECMO类型和配置标准化抗菌药物处方.
- 为了比较抗微生物药物使用的适当性和医院感染率在协议实施前后.
主要方法:
- 从2018年5月到2021年12月,对儿童患者 (<18岁) 进行了回顾性单中心研究,需要ECMO.
- 包括各种ECMO配置 (中心/外围,静脉/静脉/静脉动脉) 的医疗和心脏手术患者.
- 对抗微生物药物处方适当性和医院感染率的比较,在协议前和协议后的时期.
主要成果:
- 协议后期的患者获得适当的抗微生物药物处方的可能性是4倍 (OR4.4,P=0.036).
- 适当的处方包括预防性和治疗性抗微生物药物的使用.
- 在治疗前和治疗后组之间,没有观察到病房感染 (侵入性或整体) 发生率的显著差异.
结论:
- 一个标准化,狭窄光谱的ECMO抗微生物预防方案显著增加了适当的抗微生物处方.
- 该协议的实施成功地规范了抗菌剂的使用,而没有增加医院感染率.
- 这种方法为儿科ECMO患者的抗菌药物管理提供了一种安全有效的策略.
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