重症监护病房患者抗生素与临床结果及各种其他因素的评估

M. Ali, Saira Shahnaz, M. Jamal, Sabiha Gul, Qurrat-ul-ain Leghari, Tuba Sahar, I. Zafar, Quratulain Khan
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摘要

重症监护室(icu)是一种特殊的医院病房,为危重患者提供所需的治疗和密切监测。药物利用审查(DUR)是一种授权的、结构化的、持续的对患者用药的审查,以确保适当和合理的用药产生积极的结果。本研究的目的是评估重症监护病房(ICU)患者的抗生素和临床结果。本研究采用横断面回顾性(队列)、描述性和临床研究,纳入三级医院ICU住院患者。本研究共对ICU收治的400例患者(男53%)和(女47%)进行分析。患者年龄以41 ~ 60岁为主,占50.2%。本研究评估的患者患有多种疾病和合并症,主要包括呼吸道、感染性、肾病和泌尿科疾病。使用抗生素(以青霉素类为主)185例(46.2%),氟喹诺酮类162例(40.5%),头孢菌素287例(71.8%),碳青霉烯类102例(25.5%),万古霉素61例(15.2%),甲硝唑217例(54.2%)。52例(12.5%)患者行培养敏感性试验。64%的患者出现明显的药物相互作用。本研究死亡率高(72.8%)。观察到NI的存在和CST的缺乏增加了死亡率。CST对ICU患者抗生素治疗的选择具有重要意义。目前的研究确定了影响ICU患者发病率和死亡率的临床结果的因素。ICU大量开抗生素。由于存在药物-药物相互作用、医院感染、合并症、未进行培养敏感性试验(CST)和不良反应,死亡率增加。药剂师主导的药物审查将有助于避免所有这些问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Antibiotics and Clinical Outcomes along with Various Other Factors in Critically Ill Intensive Care Unit Patients
Intensive care units (ICUs) are special hospital wards that provide desired treatment and close monitoring of patients who are critically ill. Drug Utilization Reviews (DUR) is an authorized, structured, ongoing review of patient medication to ensure appropriate and rational medication use to yield positive outcomes. The aim of this study is to evaluate the antibiotics and clinical outcomes in intensive care unit (ICU) patients. This study was cross sectional retrospective (cohort), descriptive and clinical study including patients admitted in ICU of tertiary care hospitals. A total 400 patients (Male 53%) and (Female 47%) were admitted in ICU were analyzed in this study. Majority of patients were from age group between 41 to 60 years i.e., 50.2%. Patients evaluated in this study were suffering from many diseases and comorbidities majorly including respiratory, infectious, nephrology and urology diseases. Antibiotics, majorly penicillins were administered to 185 (46.2%) patients, flouroquinolones 162 (40.5%), cephalosporins 287 (71.8%), carbapenems 102 (25.5%), vancomycin 61 (15.2%) and metronidazole 217 (54.2%) patients. Total 52 (12.5%) patients underwent culture sensitivity test. Significant drug-drug interactions were seen in 64% patients. High mortality rate (72.8%) was seen in this study. It was observed that presence of NI and lack of CST enhanced mortality rate. CST is very important regarding choice of ICU patient’s antibiotic therapy. Current study identified factors affecting the clinical outcomes in terms of morbidity and mortality in the ICU patients. Antibiotics are prescribed in ICU abundantly. Due to presence of drug-drug interactions, nosocomial infections, comorbidities, not having culture sensitivity test (CST) and adverse reactions mortality rate was enhanced. Pharmacist led medication review will help in avoiding all these issues.
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