利用社区获得性肺炎的概率在住院患者中量身定制抗菌剂:实用性,随机试验
Jonathan D Baghdadi1,2, Anthony D Harris1,2, Lisa Pineles1,2
1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
对解读呼吸道感染测试的抗菌药物管理指南显著减少了住院成人的抗生素使用. 这种方法安全地减少了社区获得的呼吸道疾病不必要的抗生素治疗日.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
- 临床试验 临床试验
背景情况:
- 呼吸道感染是住院患者不必要的抗生素处方的主要原因.
- 目前的诊断测试 (前素,呼吸道病毒测试) 单独不能始终指导抗生素决定.
- 需要改进的策略,以优化在呼吸道感染中使用抗生素.
研究的目的:
- 评估对疑似呼吸道感染的诊断测试以抗菌管理为指导的解释的有效性.
- 为了确定这种干预措施是否可以减少住院成人的抗生素使用.
主要方法:
- 在两个医院进行了一项实用性,随机对照试验.
- 干预组通过电子健康记录模板接受了指导式的解释,对前素和呼吸道病毒测试进行了指导性解释.
- 测量的主要结果是住院抗生素治疗的几天.
主要成果:
- 干预组的抗生素治疗日数显著减少 (4.1天少;P = .006).
- 干预组76%的患者在5天内停止服用抗生素,而通常治疗组的患者为49% (P = .004).
- 没有观察到停留时间或30天再接收率的显著差异.
结论:
- 针对病毒感染的实验室测试以抗菌管理为指导的解释可以安全地减少不必要的抗生素使用.
- 这项概念验证研究表明,在社区获得的呼吸道疾病中优化抗生素处方的可行策略.
- 进一步的研究可能会在更广泛的临床环境中验证这些发现.
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