直接从血液中进行细菌检测对急性感染的成年人服用抗生素的影响:一项随机试验
David C Gaston1, Romney M Humphries1, Ariel A Lewis2
1Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
概括
直接从血液中进行细菌检测并没有缩短住院成人的抗生素持续时间. 这项研究发现,在两组之间使用万科米辛或β-乳糖抗生素没有显著差异.
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:
- 对于接受经验性治疗的住院成年人来说,降低抗生素升级至关重要,以尽量减少不良影响.
- 直接从血液中进行细菌检测对早期缓和和临床结果的影响在随机试验中尚未评估.
研究的目的:
- 为了评估直接从血液中进行的细菌检测是否与标准血液培养相比,可以促进更早的抗生素降级.
- 评估直接从血液检测对静脉注射万科米辛和抗伪体抗生素beta-lactam的持续时间的影响.
主要方法:
- 一项实用随机试验比较了直接来自血液的测试加上血液培养与单独血液培养.
- 这项研究包括500名怀疑感染的成年人,他们在急诊室接受经验性万科米辛.
- 主要结局包括静脉输入万科米辛的最后一剂时间和抗伪体抗生素β-lactam抗生素的时间.
主要成果:
- 直接从血液中检测的结果平均比标准血液培养快5.2天.
- 在最后一剂静脉注射万科米辛 (HR1.08;P=.42) 的时间内没有观察到显著的差异.
- 同样,在全身抗伪体抗生素beta-lactam抗生素的持续时间上也没有发现差异 (HR 1.04).
结论:
- 直接从血液中进行的细菌检测并没有减少静脉注射万科米辛或抗伪体抗生素β-lactam抗生素的持续时间.
- 直接从血液测试组和通常护理组之间的临床结果是可比的.
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