香港某地区医院系统抗真菌药物处方的模式及适宜性。

IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES
Ryan Y H Leung, Jimmy Y W Lam
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引用次数: 0

摘要

简介:全身性抗真菌药的消费量呈上升趋势。然而,很大比例的全身抗真菌处方是不合适的。处方不当的抗真菌药物是有问题的,但对确保适当的全身抗真菌药物处方的重视程度一直很低。关于抗真菌处方的模式和适当性的当地研究也缺乏。材料和方法:在这项回顾性、单中心、观察性研究中,通过电子病历回顾了香港一家地区医院在2023年5月1日至7月31日期间所有系统性抗真菌药物的住院处方。系统性抗真菌处方的适宜性由单一审稿人通过其适应症、剂量、持续时间和抗真菌伴随药物相互作用来评估。结果:共收集处方单177张。伊曲康唑、米卡芬净和氟康唑是处方最多的全身抗真菌药物。血液科、传染病科和ICU是本研究中主要的系统抗真菌处方者。全身抗真菌处方的总体适宜性为27.7%(49/177),其中适应症适宜性为72.9%(129/177),剂量适宜性为57.1%(101/177),持续时间适宜性为91.5%(162/177),抗真菌伴随药物相互作用适宜性为71.6%(127/177)。三唑类抗真菌药物的处方总体适宜性仅为15%,比非三唑类抗真菌药物更容易出现处方不适宜性(p < 0.001)。常见的处方缺陷包括:(i)对生长念珠菌的痰培养开始进行全身抗真菌治疗,(ii)伊曲康唑胶囊有争议的预防,(iii)忽视潜在的严重抗真菌药物相互作用。结论:不适当的全身抗真菌药物处方在香港并不罕见。在公立医院建立抗真菌管理计划可能是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Patterns and Appropriateness of Systemic Antifungal Prescriptions in a Regional Hospital in Hong Kong.

Introduction: The consumption of systemic antifungals is on the rise. However, a significant proportion of systemic antifungal prescriptions is inappropriate. Inappropriately prescribed antifungals are problematic, but there has been minimal emphasis on ensuring the appropriate prescription of systemic antifungals. Local studies regarding the patterns and appropriateness of antifungal prescriptions are also lacking.

Materials and methods: In this retrospective, single-centre, observational study, every in-patient prescription order of systemic antifungals in a regional hospital in Hong Kong between 1 May and 31 July 2023 was reviewed via electronic patient records. The appropriateness of a systemic antifungal prescription was assessed by its indication, dosage, duration and antifungal-concomitant drug interactions by a single reviewer.

Results: A total of 177 prescriptions orders were collected. Itraconazole, micafungin and fluconazole were the most prescribed systemic antifungals. The haematology team, infectious disease team and ICU were the major systemic antifungal prescribers in this study. The overall appropriateness of systemic antifungal prescriptions was 27.7% (49/177), with an appropriateness of 72.9% (129/177) for indications, 57.1% (101/177) for dosage, 91.5% (162/177) for duration and 71.6% (127/177) for antifungal-concomitant drug interactions. Triazole antifungals had an overall prescription appropriateness of only 15% and were more likely to be prescribed inappropriately than non-triazole antifungals (p < 0.001). Common prescription pitfalls include (i) starting a systemic antifungal for sputum culture that grew Candida spp., (ii) debatable prophylaxis with itraconazole capsules, (iii) overlooking potentially serious antifungal-drug interactions.

Conclusions: Inappropriate systemic antifungal prescription is not uncommon in Hong Kong. Establishing an antifungal stewardship programme in public hospitals may be beneficial.

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来源期刊
Antibiotics-Basel
Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
7.30
自引率
14.60%
发文量
1547
审稿时长
11 weeks
期刊介绍: Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.
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