Brayan Miranda-Chavez, Andre Fuentes-Yufra, Miguel Hueda-Zavaleta, Cesar Copaja-Corzo, Javier A Flores-Cohaila, Marco Rivarola-Hidalgo
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引用次数: 0
摘要
目的确定并分析秘鲁南部一家医院临终病人的抗生素处方模式及相关因素:对秘鲁塔克纳市丹尼尔-阿尔西德斯-卡里翁第三医院(Hospital III Daniel Alcides Carrion)2023年死亡的成年患者进行了横断面分析研究。数据来自电子病历,重点是最后一次住院期间抗生素的使用情况。使用泊松回归法进行了单变量、双变量和多变量分析,以调整潜在的混杂因素:研究共纳入 239 名患者,平均年龄为 76 岁。93.72%的患者使用了抗生素,42.46%的患者未发现感染病灶。头孢曲松、美罗培南和万古霉素是使用最多的抗生素。死亡前72小时内抗生素使用率较低与住院时间超过18天和患有2种或2种以上合并症有关:生命末期抗生素使用率较高,且通常没有感染病灶,这表明需要更好的姑息治疗指南和教育,以避免不适当的抗生素处方。加强医疗服务提供者、患者和家属之间的沟通对于优化临终关怀至关重要。
The Use of Antibiotics at the End of Life: A Cross-Sectional Study.
Objective: To identify and analyze antibiotics' prescription patterns and associated factors among terminally ill patients at a hospital in southern Peru.
Methodology: A cross-sectional analytical study was conducted on adult patients who died in Hospital III Daniel Alcides Carrion in Tacna, Peru, 2023. Data were collected from electronic medical records, focusing on antibiotic use during the last hospitalization. Univariate, bivariate, and multivariate analyses were performed using Poisson regression to adjust for potential confounders.
Results: The study included 239 patients with an average age of 76. Antibiotics were administered to 93.72% of patients, with 42.46% lacking an identified infectious focus. Ceftriaxone, Meropenem, and Vancomycin were the most used antibiotics. A lower use of antibiotics within 72 hours prior to death was associated with hospitalizations longer than 18 days and having 2 or more comorbidities.
Conclusion: The high prevalence of antibiotic use at the end of life, often without an infectious focus, suggests a need for better guidelines and education on palliative care to avoid inappropriate antibiotic prescribing. Improved communication between healthcare providers, patients, and families is essential for optimizing end-of-life care.