实施复杂的门诊抗微生物治疗方案是否可以减少骨和关节感染患者的再入院?
Elizabeth Thottacherry1, Marten Hawkins2, Jallisae Nedi3
1Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|January 29, 2026
概括
由先进实践提供者 (APP) 领导的一项新的复杂门诊抗菌疗法 (COpAT) 计划显著改善了骨和关节感染患者的出院后随访. 这一举措加强了抗菌药物监测,但并没有显著减少医院再入院.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 骨和关节感染需要长时间的抗微生物治疗和密切监测.
- 转换护理 (TOC) 服务对于管理复杂的门诊抗菌疗法 (COpAT) 至关重要.
- 先进实践提供者 (APP) 在领导COpAT计划中的作用需要进一步评估.
研究的目的:
- 评估APP领导的COpAT计划对出院后患者随访的影响.
- 评估该计划对医院再入院率的影响.
- 在COpAT计划中确定TOC服务的有效性.
主要方法:
- 采用了实施前后的队列研究设计.
- 该研究比较了COpAT计划启动6个月前和5个月后的结果.
- 该干预涉及APP领导的多学科团队,为患有骨和关节感染的患者提供TOC服务.
主要成果:
- 平均出院后的随访时间显著减少,从20.1天减少到9.1天 (P < .001).
- 在14天内看到的患者比例从42%增加到83% (P < .001).
- 住院再接收率和急诊室访问没有显著变化;然而,TOC药房的参与率大幅增加 (8%至42%,P<.001).
结论:
- 由APP领导的结构化COpAT计划,涉及TOC药房,优化出院后的随访.
- 该计划加强门诊抗菌药物监测,并支持对复杂感染的及时干预.
- APP和TOC药房的合作有效地解决了药物错误,副作用和治疗修改.
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