评估抗生素治疗的适当性:对定义及其临床影响的范围审查
Lea A Nikolai1, Beryl P Gladstone1,2, Arisa Hakariya1
1Division of Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Otfried Müller Str 12, Tübingen, Germany.
Infection
|January 31, 2026
概括
在研究中,适当的抗生素治疗 (AAT) 定义通常只关注易感性,而不是更广泛的抗菌管理 (AMS) 原则. 需要标准化,多维的AAT定义来准确评估患者的结果.
科学领域:
- 传染性疾病 传染性疾病
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
背景情况:
- 适当的抗生素治疗 (AAT) 对患者的治疗结果至关重要.
- 目前在研究中的AAT定义主要侧重于体外易感性.
- 抗微生物药物管理 (AMS) 原则主张更广泛的定义,包括剂量,途径和持续时间.
研究的目的:
- 描述AAT在临床研究中的定义.
- 检查AAT定义特征与患者结果之间的关联.
主要方法:
- 对细菌感染的住院成年人AAT的观察性研究 (2011-2021) 的范围审查.
- 提取和分类经验和确定的AAT的定义.
- 分析了定义特征和报告结果之间的关联.
主要成果:
- 几乎所有288项研究都定义了AAT,主要依赖于体外敏感性 (40.7%经验,31.7%确定的).
- 其他因素,如剂量和持续时间不一致地应用和运行.
- 经验性AAT在62.8%的研究中改善了结果,但关联根据定义复杂性差异很小,除非包括治疗持续时间.
结论:
- 研究中的AAT定义主要是基于易感性,与AMS不一致.
- 需要标准化,多维的AAT定义,包括临床,药物和管理标准.
- 这将改善研究的可比性和对AAT对患者结果的真正影响的理解.
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