系列体检以减少新生儿不必要的抗生素暴露:基于人口的研究
Anlaug Vatne1, Beate Horsberg Horsberg Eriksen2,3, Fabian Bergqvist4
1Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway anlaug.vatne@sus.no.
Archives of disease in childhood. Fetal and neonatal edition
|November 19, 2025
概括
连续体检 (SPE) 在未影响安全结果的情况下,在患有早期败血症 (EOS) 风险的婴儿中,安全地减少了50%的早期抗生素暴露. 这种方法有助于在新生儿重症监护室 (NICU) 合理使用抗生素.
科学领域:
- 新生儿医学 新生儿医学
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
背景情况:
- 在新生儿重症监护病房 (NICU) 中,过度使用抗生素对患有早期性败血症 (EOS) 风险的婴儿构成了挑战.
- 诊断的不确定性导致多达12.0%的未感染婴儿不必要接触抗生素.
- 开发安全,有效的策略来减少早期的抗生素暴露是至关重要的.
研究的目的:
- 评估连续体检 (SPE) 的安全性和有效性,以减少患有EOS风险的婴儿早期抗生素暴露.
- 评估SPE对关键安全结果的影响,包括EOS发生率和与感染相关的不良事件.
主要方法:
- 这是一项基于人口的多中心干预研究,该研究于2018年至2021年在挪威6个新生儿急诊中心进行.
- 包括54,713名出生在妊娠34周或之后的活产婴儿,这些婴儿有EOS的风险.
- 实施24-48小时的SPE协议进行临床监测,根据临床症状和稳定性指导抗生素的开始.
主要成果:
- 患有EOS风险的婴儿的抗生素暴露减少了50%,从1.8%降至0.9%.
- 培养物阳性EOS的发生率,新生儿重症监护室入院率和整体安全结果保持不变.
- 对于确诊的EOS或与感染有关的再入院,在服用抗生素后的时间内没有观察到任何显著差异.
结论:
- 连续体检 (SPE) 是一种安全有效的策略,用于减少早期发病败血症 (EOS) 风险的婴儿不必要的抗生素暴露.
- 这种方法可以在新生儿重症监护室 (NICU) 合理使用抗生素,而不会影响患者的安全.
- SPE支持新生儿败血症管理中的基于证据的临床决策.
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