2013-2020 年因无并发症社区获得性肺炎住院的成人接受抗生素治疗的时间。

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Infection Control and Hospital Epidemiology Pub Date : 2024-06-01 Epub Date: 2024-02-14 DOI:10.1017/ice.2024.14
Natalie L McCarthy, James Baggs, Hannah Wolford, Sophia V Kazakova, Sarah Kabbani, Brandon K Attell, Melinda M Neuhauser, Lindsey Walker, Sarah H Yi, Kelly M Hatfield, Sujan Reddy, Lauri A Hicks
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引用次数: 0

摘要

目标:2014 年美国《抗生素耐药菌国家战略》(CARB)旨在到 2020 年将住院病人抗生素的不当使用减少 20%,如社区获得性肺炎(CAP)。我们评估了从 2013 年到 2020 年因无并发症 CAP 而住院的成人的治疗时间(LOT)的年度趋势:我们使用 MarketScan 和美国医疗保险与医疗补助服务中心数据库中的国际疾病分类第九版和第十版代码,对主要诊断为细菌性或不明原因肺炎的成人进行了一项回顾性队列研究。我们纳入了住院时间(LOS)为 2-10 天、出院回家后能自我护理且出院后 3 天内未再次住院的患者。我们根据 PINC AI 医疗保健数据库中的住院时间估算了住院患者的 LOT。总LOT的计算方法是将估计的住院LOT和实际出院后LOT相加。我们研究了总LOT>7天的患者从2013年到2020年的趋势,这被认为是LOT可能过长的指标:年龄在 18-64 岁和≥65 岁的无并发症 CAP 住院患者分别为 44976 人和 400928 人。从 2013 年到 2020 年,LOT 总天数大于 7 天的患者比例在 18-64 岁的患者中下降了 25%(68%-51%),在年龄≥65 岁的患者中下降了 27%(68%-50%):尽管自 2013 年以来,无并发症 CAP 患者可能过度使用抗生素的情况有所减少,但到 2020 年,使用抗生素超过 7 天的患者比例仍超过 50%。抗生素管理项目应继续采取干预措施,以减少常见感染的可能过度LOT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Length of antibiotic therapy among adults hospitalized with uncomplicated community-acquired pneumonia, 2013-2020.

Objective: The 2014 US National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) aimed to reduce inappropriate inpatient antibiotic use by 20% for monitored conditions, such as community-acquired pneumonia (CAP), by 2020. We evaluated annual trends in length of therapy (LOT) in adults hospitalized with uncomplicated CAP from 2013 through 2020.

Methods: We conducted a retrospective cohort study among adults with a primary diagnosis of bacterial or unspecified pneumonia using International Classification of Diseases Ninth and Tenth Revision codes in MarketScan and the Centers for Medicare & Medicaid Services databases. We included patients with length of stay (LOS) of 2-10 days, discharged home with self-care, and not rehospitalized in the 3 days following discharge. We estimated inpatient LOT based on LOS from the PINC AI Healthcare Database. The total LOT was calculated by summing estimated inpatient LOT and actual postdischarge LOT. We examined trends from 2013 to 2020 in patients with total LOT >7 days, which was considered an indicator of likely excessive LOT.

Results: There were 44,976 and 400,928 uncomplicated CAP hospitalizations among patients aged 18-64 years and ≥65 years, respectively. From 2013 to 2020, the proportion of patients with total LOT >7 days decreased by 25% (68% to 51%) among patients aged 18-64 years and by 27% (68%-50%) among patients aged ≥65 years.

Conclusions: Although likely excessive LOT for uncomplicated CAP patients decreased since 2013, the proportion of patients treated with LOT >7 days still exceeded 50% in 2020. Antibiotic stewardship programs should continue to pursue interventions to reduce likely excessive LOT for common infections.

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来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
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