以家庭为基础的初级保健人群治疗尿路感染时抗生素的正确使用。

CONSULTANT PHARMACIST Pub Date : 2018-02-01 DOI:10.4140/TCP.n.2018.105

Megan E Gee, James Ford, Erin L Conway, Michael C Ott, John A Sellick, Kari A Mergenhagen

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引用次数: 4

摘要

目的:评价2006 - 2015年退伍军人卫生系统家庭基层护理人群尿路感染(UTI)的诊断和治疗趋势。设计:回顾性队列研究。背景:退伍军人医疗保健系统。参与者:2006年至2015年接受尿路感染治疗的家庭初级保健患者。干预措施:没有。主要结局指标:根据McGeer标准确定合适的治疗方法。采用多变量logistic回归来确定导致尿路感染适当治疗的因素。结果:在366例患者中，68例(18.6%)接受了尿路感染检测。26%的患者接受了适当的治疗。对任何抗生素过敏都会增加适当治疗的几率(优势比[OR] = 5.6, 95%可信区间[CI] 1.5-23.2)。侧腹疼痛和尿频增加也增加了接受适当治疗的可能性(OR = 25.9, 95% CI 2.9-584.0和OR = 4.49, 95% CI 0.99-21.2)。结论:抗菌药物在治疗尿路感染中存在滥用现象。伴有侧腹疼痛、尿频增加和抗生素过敏的患者更有可能接受适当的治疗。因此，药剂师有一个可行的机会，以增加适当的抗生素处方在家庭基础的初级保健人群。

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Proper Antibiotic Use in a Home-Based Primary Care Population Treated for Urinary Tract Infections.

Objective: To evaluate the trends associated with diagnosis and treatment of urinary tract infections (UTI) in a home-based primary care population of Veterans Health System patients from 2006 to 2015.

Design: Retrospective cohort study.

Setting: Veterans Healthcare System.

Participants: Home-based primary care patients treated for UTI from 2006 to 2015.

Interventions: None.

Main outcome measure: Appropriate therapy was determined based on the McGeer criteria. Multivariate logistic regression was used to determine factors leading to appropriate UTI treatment.

Results: Of 366 available patients, 68 (18.6%) were tested for a UTI. Appropriate therapy occurred in 26% of patients. Allergy to any antibiotic increased the odds of appropriate treatment (odds ratio [OR] = 5.6, 95% confidence interval [CI] 1.5-23.2). Flank pain and increased urinary frequency also increased the likelihood of being treated appropriately (OR = 25.9, 95% CI 2.9-584.0 and OR = 4.49, 95% CI 0.99-21.2, respectively).

Conclusion: Antibiotics were overused for treating UTIs in the homebound population. Patients with flank pain, increased urinary frequency, and antibiotic allergy were more likely to receive appropriate treatment. Pharmacists, therefore, have a viable opportunity to increase appropriate antibiotic prescribing in the home-based primary care population.

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来源期刊

CONSULTANT PHARMACIST PHARMACOLOGY & PHARMACY-

自引率

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期刊介绍： Vision ... The Society"s long-term desire, aspiration, and core purpose. The vision of the American Society of Consultant Pharmacists is optimal medication management and improved health outcomes for all older persons. Mission ... The Society"s strategic position, focus, and reason for being. The American Society of Consultant Pharmacists empowers pharmacists to enhance quality of care for all older persons through the appropriate use of medication and the promotion of healthy aging.