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通过尿液培养后续计划改善门诊抗菌药物管理,利用药剂师主导的症状评估

Benjamin Muron¹, Lisa Dumkow¹, Kamah Ellena¹

¹Department of Pharmacy, Trinity Health Grand Rapids, Grand Rapids, MI, USA.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

|March 12, 2026

概括

对于尿液培养呈阳性但没有症状的患者,不开抗生素是有效的管理干预措施. 这种方法可以防止不必要的抗生素暴露,而不会影响尿路感染的临床结果.

科学领域:

传染性疾病传染性疾病
临床药房临床药房
抗微生物药物管理委员会

背景情况:

在急诊室 (ED) 和紧急护理 (UC) 设置中的阳性尿液培养通常会导致抗生素处方.
对无症状细菌尿的抗生素使用的适当性需要仔细评估.
药剂师领导的后续计划可以促进临床评估和干预.

研究的目的:

根据药剂师的症状评估,比较服用抗生素和不服用抗生素的尿液培养阳性患者的临床结果.
评估药剂师进行的门诊培养后续计划在指导抗生素处方决策方面的有效性.

主要方法:

成年女性患者的回顾性队列研究,从ED/UC访问中获得阳性尿液培养.
根据症状,患者被分类为标准护理 (SOC) 带有抗生素治疗或没有新抗生素处方的干预.
主要结局是30天内治疗症状性尿路感染;次要结局包括不良事件和Clostridioides difficile感染.

主要成果:

两组之间30天内症状性尿路感染治疗没有显著差异 (14.4%的SOC与11.1%的干预).
与干预组 (83.5%) 相比,无症状患者在SOC组中较少 (53%).
药剂师的随访是有效的,平均需要1次接触尝试和每位患者15分钟.

结论:

对具有阳性尿液培养的无症状患者不开抗生素是适当的抗菌管理干预措施.
这一策略有效地防止在ED和UC环境中不必要的抗生素暴露.
药剂师主导的症状评估是优化抗生素使用的宝贵工具.

关键词:

抗微生物药物管理管理抗微生物药物抗微生物药物文化后续行动文化后续行动紧急服务部门药剂师药剂师尿路感染尿路感染尿液培养是一种文化.

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