某三级大学医院传染病住院会诊的影响

R. Waked, Danielle Jaafar, M. Chedid, G. Saliba, E. Haddad, J. Choucair
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摘要

背景:传染病专家的角色在不断演变。本研究的目的是为了证明传染病会诊在住院病人中的价值。方法:这是一项前瞻性队列研究,发生在三级保健大学医院。2016年4月至6月,对224例应传染病会诊要求在该院接受抗生素治疗的患者进行评估。评估了以下变量:转诊部门、会诊目的、在要求进行传染病会诊前使用的抗生素、在传染病就诊后抗生素的修改情况,以及何时将抗生素使用改为单药或双药治疗。结果:请求次数最多的科室为肿瘤科(23.2%)和泌尿科(21.4%)。咨询的目的是诊断(29%),治疗(41%),诊断和治疗(21%)和预防(9%)。以每100名住院病人4.9人的比率进行传染病咨询。14.7%的病例停用抗生素。11.6%的病例没有抗生素治疗的指征。25.4%的病例修改了抗生素治疗。仅1例调整抗生素用量。碳青霉烯类抗生素停药占31.6%,喹诺酮类抗生素停药占22.7%。结论:传染病会诊有助于优化住院患者疑似或确诊感染的诊断和治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of the inpatient infectious disease consultations at a tertiary care university hospital
BACKGROUND: The role of the infectious disease specialist continues to evolve. The purpose of this study is to demonstrate the value of infectious disease consultation in the inpatient setting. METHODS: This is a prospective cohort study that took place in a tertiary care university hospital. During the period from April to June 2016, 224 cases of patients receiving antibiotics in the hospital with the request of an infectious diseases’ consultation, were evaluated. The following variables were assessed: the referring department, purpose of the consultation, the antibiotic used before requesting the infectious diseases consultation, the antibiotic modifications after the infectious disease’s visit, whenever the antibiotic usage was switched to a mono or bi-therapy. RESULTS: The most frequent requesting departments were Oncology (23.2%) and Urology (21.4%). The purpose of the consultations was diagnosis (29%), therapy (41%), both diagnosis and therapy (21%), and prophylaxis (9%). An infectious diseases consultation was given at a rate of 4.9 consultations per 100 hospitalized patients. Antibiotic was discontinued in 14.7% of cases. There was no indication for the antibiotic treatment in 11.6% of cases. Modifying the antibiotic therapy was done in 25.4% of cases. Adjusting the antibiotic dosage was done in only one case. Carbapenem antibiotics were discontinued in 31.6 % of cases and Quinolones discontinuation accounted for 22.7% of cases. CONCLUSION: Infectious disease consults contributed to the optimization of the diagnostic and therapeutic approaches for suspected or confirmed infections in hospitalized patients.
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