评估电子β-乳酸过敏报警抑制对抗生素处方实践的影响
J Morgan Knight1, Brandon Hawkins1, Erin Anderson1
1University of Tennessee Medical Center, Knoxville, TN, USA.
概括
抑制不必要的β-乳酸过敏警报减少了使用替代抗生素,如卡巴烯和单菌药. 这种策略似乎是安全的,没有增加新的过敏文档,使其在临床上对抗生素选择具有意义.
科学领域:
- 传染性疾病 传染性疾病
- 临床药房 临床药房
- 医疗信息学 医疗信息学
背景情况:
- 由于过敏警报,人们经常避免服用β-乳酸抗生素,即使交叉反应不太可能.
- 不必要的避开β-乳酸胺可以导致使用更广泛的替代抗生素,可能导致抗生素耐药性.
- 选择性警报抑制旨在通过减少不必要的避开β-乳糖胺来优化抗生素处方.
研究的目的:
- 评估基于侧链不相似性的抑制β-乳酸过敏警报是否可以安全地减少替代抗生素的使用.
- 评估选择性抑制警报对卡巴,单巴和非β-lactam剂的处方的影响.
主要方法:
- 一个学术医疗中心的回顾性准实验研究.
- 对接受抗生素治疗的819名成年患者遇到有记录的β-乳酸过敏的分析.
- 在 (2020年8月-2022年9月) 之前和之后 (2022年10月-2024年3月) 处方抗生素的比较. 报警抑制实施.
主要成果:
- 替代药物的复合处方 (carbapenem,monobactam,aztreonam) 显著降低了警报后抑制 (25.4%与15.0%,P=0.016).
- 没有观察到单个药物处方或替代药物使用季度趋势的显著变化.
- 关于新的β-乳酸过敏的记录在抑制前和抑制后的时期之间仍然可比.
结论:
- 选择性抑制β-乳酸过敏警报显著减少了替代抗生素最初的复合处方.
- 这些发现表明,这种警报抑制策略是安全的,并且在优化抗生素选择方面具有临床益处.
- 这种方法可能有助于保持β-乳糖抗生素的功效,并减轻替代药物的过度使用.
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