细菌感染住院病人静脉注射铁剂:使用情况和结果。

Journal of Maine Medical Center Pub Date : 2024-01-01 Epub Date: 2024-06-18 DOI:10.46804/2641-2225.1176
Nicolette Centanni, Jennifer Hammond, Joshua Carver, Wendy Craig, Stephanie Nichols
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引用次数: 0

摘要

导言:鉴于静脉注射铁剂治疗的不确定性和潜在的感染风险,医疗服务提供者可能会犹豫是否使用这种制剂来治疗住院的细菌感染患者,即使有临床指征也是如此。本研究旨在探讨因细菌感染而住院治疗的患者使用静脉注射铁剂的模式及其相关临床结果:这项回顾性病历审查评估了 2019 年在缅因州医疗中心同一入院期间同时接受静脉注射蔗糖铁剂和抗生素治疗的成年患者。收集的数据包括铁剂研究、静脉注射铁剂的处方方法和临床结果。数据采用描述性统计进行总结:共评估了 197 名患者。抗生素治疗的中位持续时间为 5(4-9)天。153例(77.7%)患者的铁剂和抗生素治疗重叠,平均重叠时间为2.7(1-7)天。在 44 名没有重叠用药的患者中,有 20 人(46%)在使用抗生素前接受了静脉注射铁剂。超过一半(57%)的感染类型涉及泌尿道和呼吸系统。约2%的患者需要扩大抗生素治疗范围或延长治疗时间,7%的患者死亡,16%的患者在出院后30天内再次入院:讨论:之前评估静脉注射铁剂感染风险的研究结果相互矛盾。这是唯一一项对因感染而接受静脉注射铁剂和抗生素治疗但未在住院期间进行血液透析的患者的治疗结果进行分析的研究。尽管我们的研究结果支持静脉注射铁剂治疗对合并感染和铁缺乏症的患者是安全的,但这一结果可能并不适用于所有临床亚组:本研究表明,在本院急性细菌感染患者接受静脉注射铁剂治疗时,大多数患者不会出现不良后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intravenous Iron in Patients Hospitalized with Bacterial Infections: Utilization and Outcomes.

Introduction: Given the uncertainties related to IV iron therapy and the potential risk of infection, health care providers may hesitate to use this preparation to treat hospitalized patients with bacterial infections, even if clinically indicated. The aim of this study was to examine patterns of prescribing IV iron in patients who were hospitalized and treated for a bacterial infection, and their associated clinical outcomes.

Methods: This retrospective chart review evaluated adult patients who received both IV iron sucrose and antibiotics during the same admission at Maine Medical Center in 2019. Data collected included iron studies, practices for prescribing IV iron, and clinical outcomes. Data were summarized using descriptive statistics.

Results: A total of 197 patients were evaluated. The median duration of antibiotic therapy was 5(4-9) days. Iron and antibiotic administration overlapped in 153(77.7%) patients, with a mean overlap of 2.7(1-7) days. In the 44 patients without overlap, 20(46%) received IV iron before antibiotics. More than half (57%) of infection types involved urinary tract and respiratory systems. Approximately 2% of patients had antibiotic therapy broadened or duration extended, 7% died, and 16% were readmitted within 30 days of discharge.

Discussion: Prior studies evaluating the risk of infection with IV iron published conflicting results. This is the only study that analyzed outcomes in patients receiving IV iron and antibiotics for infection but not undergoing hemodialysis during a hospital admission. Although our findings support that IV iron treatment is safe among patients with concomitant infection and iron deficiency, this finding may not be the case for all clinical subgroups.

Conclusions: This study showed that when patients were administered IV iron in the setting of acute bacterial infection in our facility, most patients did not have negative outcomes.

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