在使用临床决策支持系统的手术患者中优化术后抗菌疗法:使用模式和临床结果
Miguel Ángel Amor García1, Irene Orozco Cifuentes1, Raquel Moreno Díaz1
1Pharmacy Service, Hospital Universitario Infanta Cristina, 9 de Junio, Av. 2, 28981 Parla, Spain.
Medicina (Kaunas, Lithuania)
|November 27, 2025
概括
临床决策支持系统 (CDSS) 将手术患者的抗微生物药物使用量减少了4.4%,并降低了成本. 这种抗菌药物管理工具还减少了在特定服务中停留的时间,但没有影响死亡率.
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
- 手术护理 手术护理
背景情况:
- 抗微生物药物管理在手术中至关重要,以打击与医疗保健相关的感染和抗微生物药物耐药性.
- 临床决策支持系统 (CDSS) 可以优化抗菌素处方,但它们对手术患者的影响需要更多证据.
研究的目的:
- 评估CDSS对手术患者术后抗微生物治疗的影响.
- 评估CDSS实施后对抗微生物消费,支出和临床结果的变化.
主要方法:
- 在一家初级医院进行了一项准实验性的时间序列研究.
- 分析了手术患者在实施CDSS之前 (2017年4月至2020年9月) 和之后 (2020年10月至2024年3月) 的数据.
- 测量了抗微生物消费 (DDDs/1000患者日),支出 (€/1000患者日),死亡率和停留时间 (LOS).
主要成果:
- 总体抗菌药物消费量下降了4.4%,在特定的抗生素类别中出现了显著的减少.
- 支出显示下降趋势 (-14.2%). 在泌尿病学 (5至4天) 和创伤学 (16至8.5天) 观察到显著的LOS减少.
- CDSS产生了476条管理建议,76.1%的接受率,经常涉及抗菌药物停用或过渡到口服治疗.
结论:
- 在手术环境中实施CDSS减少了抗微生物药物的消费和支出,并且对管理建议的接受度很高.
- 死亡率保持稳定,在特定的外科手术服务中减少的LOS表明这种方法是安全的,并且可能是有效的.
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