退院后使用抗生素和C.之间的关联 难以测试作为临床显著腹的替代品
Daniel J Livorsi1,2, James Merchant3, Hyunkeun Cho3
1Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|October 23, 2025
概括
出院后的抗生素在住院患者中增加了40-56%的Clostridioides difficile检测的风险. 在出院时优化抗生素的使用可以帮助减少这种风险.
科学领域:
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 出院后使用抗生素是常见的,但往往不理想或不必要.
- 临床上显著的腹,通常是由Clostridioides difficile (C. diff) 引起的,是与抗生素治疗相关的潜在不良事件.
研究的目的:
- 量化C. diff的风险测试,临床显著腹的替代品,在最近住院的病人治疗后释放抗生素.
- 为了确定影响C.diff风险的因素,在医院出院后进行检测.
主要方法:
- 从2018年到2021年,退伍军人卫生管理局 (VHA) 超过160万例住院病人的回顾性队列研究.
- 暴露被定义为接受出院后的抗生素.
- 主要结局是释放后30天内进行C. diff测试的时间,使用Cox比例危险模型进行分析.
主要成果:
- 近20%的入院者接受了出院后的抗生素治疗.
- 与未服用这些药物的患者相比,接受退院后抗生素的患者患C.diff检测的风险增加了40-56%.
- 接受抗生素治疗的患者的中位时间比未接受抗生素治疗的患者 (14.1天) 短 (6.7天).
结论:
- 出院后的抗生素处方与C.diff检测的风险显著增加有关.
- 优化在出院时的抗生素处方,包括减少持续时间和避免高风险药物,对于减轻患者风险至关重要.
- 这些发现支持了在医院出院后降级抗生素治疗的努力.
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