评估三级医院重症监护室抗生素处方模式的前瞻性观察研究

Drashti Shukla, Dhwani Desai, Rutvi Vaidya, Shivali Patel, Kushal Patil
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摘要

研究目的:本研究旨在评估重症监护病房重症患者和术后患者的抗生素使用模式,目的是优化处方实践、评估指南遵守情况以及最大限度地降低与抗生素耐药性相关的风险。研究设计:前瞻性观察。研究地点和时间:苏拉特 BAPS Pramukh Swami 医院,2022 年 11 月至 2023 年 3 月。材料与方法:研究包括 108 名直接入住重症监护室的患者,这些患者是根据特定的纳入标准筛选出来的。符合条件的患者年龄在 18 岁或以上,被归类为需要入住重症监护室的重症患者或术后患者。此外,患者需要至少服用过一种抗生素,无论是预防性还是治疗性的。使用预先制定的病例报告表记录每位患者的详细人口统计学和临床数据。研究旨在分析这些重症监护室患者中与抗生素使用相关的不良事件,并使用 Microsoft Excel 进行数据分析。研究结果处方抗生素总数为 235 种,经验性处方抗生素为头孢哌酮+舒巴坦 54 种(21%),其次是头孢曲松(14%)和美罗培南(12%)。63(58%)名患者接受了多重治疗。使用最多的是世卫组织观察级别的药物,有 163 人(69%)。平均每次使用抗生素的次数为 2.15 次(世卫组织最佳值:1.6 - 1.8 次)。有 16 名患者出现了与抗生素相关的不良反应。对 28.7% 的患者进行了培养敏感性检测。最常见的病原体是大肠杆菌和肺炎双球菌。结论这项研究反映了抗菌药物管理实践的要求,其重点应放在促进合理的抗生素处方上,这将有助于应对未来严重的耐药性问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Prospective Observational Study to Assess the Prescription Pattern of Antibiotics in Intensive Care Unit at Tertiary Care Hospital
Aims: The aim of the study is to assess antibiotic utilization patterns among critically ill and post-operative ICU patients, with the goals of optimizing prescribing practices, evaluating adherence to guidelines, and minimizing risks associated with antibiotic resistance. Study Design: Prospective Observational. Place and Duration of Study: BAPS Pramukh Swami Hospital, Surat between November 2022-March 2023. Materials and Methods: The study included 108 patients directly admitted to the ICU, selected based on specific inclusion criteria. Eligible patients were aged 18 years or older and categorized as critically ill or post-operative patients requiring ICU admission. Additionally, patients needed to have been prescribed at least one antibiotic, whether for prophylactic or therapeutic purposes. Detailed demographic and clinical data were recorded for each patient using a pre-established case report form. The study aimed to analyze adverse events associated with antibiotic usage among these ICU patients, utilizing Microsoft Excel for data analysis. Results: The total number of prescribed antibiotics was 235, the empirically prescribed antibiotics were Cefoperazone + Sulbactam 54 (21%) followed by Ceftriaxone (14%) and Meropenem (12%). The multiple therapy was prescribed in 63 (58%) patients. The most utilized were from WHO Watch Class 163 (69%). The value obtained for the average number of antibiotics per encounter was 2.15 (WHO optimal value: 1.6 – 1.8). The adverse events associated with antibiotics were observed in 16 patients. A culture sensitivity test was performed in 28.7% of patients. The most common pathogen detected was E.coli and K. pneumoniae. Conclusion: The study reflects the requirement of antimicrobial stewardship practice, which should focus on promoting rational antibiotic prescription, which will help in combat with critical resistance issues in the future
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