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最佳光谱抗生素比率用于评估由グラム阴性细菌引起的败血症中的抗生素使用情况

Reid Goodman¹, Alice Bewley¹, Andrew Atkinson²

¹Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.

|January 11, 2026

概括

这项研究引入了最佳谱抗生素比率 (OSAR) 来衡量抗生素谱的适当性,补充了像SAAR这样的持续时间指标. OSAR揭示了各医院抗生素使用和治疗不足的差异,指导了抗菌药物管理.

科学领域:

传染性疾病传染性疾病
临床微生物学临床微生物学
医疗保健服务研究医疗服务研究

背景情况:

准确的抗微生物消费监测对于有效的管理干预至关重要.
医院报告使用CDC标准化抗菌药物管理比率 (SAAR) 的抗生素持续时间.
需要一个衡量抗微生物频谱的指标,补充SAAR并考虑局部耐药性模式.

研究的目的:

开发和评估最佳光谱抗生素比率 (OSAR),作为评估抗菌谱适宜性的新型指标.
将OSAR与SAAR和抗生素谱系指数 (ASI) 等现有指标进行比较.
为了确定实证和定向抗生素频谱使用和医院治疗不足的变化.

主要方法:

在9家医院 (2018-2023) 进行了成年败血症患者与格拉姆阴性细菌 (GNB) 感染的回顾性队列研究.
定义的抗生素有效光谱 (AES) 是敏感的GNB与所有培养的GNB的比率.
计算经验和定向OSAR作为临床选择AES与最佳AES的比率,并与SAAR和ASI进行比较.

主要成果:

分析了来自7997名患者的10,277个GNB分离物;AES从0.15 (安培) 到0.94 (阿米卡辛) 不同.
经验性OSAR在1.08至1.89之间,总体经验性治疗不足率为13.6%,医院变化显著.
定向的OSAR范围从0.74到1.45,OSAR,SAAR和ASI随着时间的推移在各医院显示出不同的趋势.

结论:

OSAR提供了一个对基于持续时间的指标 (如SAAR) 进行补充的视角,用于评估抗生素利用率.
基于局部和个体耐药性数据,OSAR有效评估抗生素谱的适当性.
该研究强调了抗生素频谱使用和治疗不足的显著差异,强调了需要量身定制的管理干预措施的必要性.

关键词:

抗生素光谱抗生素光谱抗菌剂的使用抗菌剂的使用格拉姆阴性细菌是什么?数学优化的数学优化.

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