短期住院病房出院患者的抗生素治疗持续时间

CM Pinto-Nieto, P. C. Baena, J. C. Mangana, A. M. Rosa, B. C. Robles, MA Garre Gonzalvez, G. Corral, M. H. Expósito, J. Plata, M. Vida
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引用次数: 0

摘要

背景和重要性缩短抗生素治疗时间是减少抗生素压力的基础之一,因此,抗菌素耐药性的出现目的和目的描述短期住院病房出院患者的抗生素治疗时间,并根据目前基于证据的建议分析抗生素治疗时间。材料和方法于2020年1月在一家短期住院病房进行了一项描述性、回顾性、横断面研究。患者年龄≥14岁,出院时有抗生素处方。收集的数据包括:年龄、性别、平均住院天数、抗生素处方和抗生素临床指征。数据是从患者的电子健康记录中收集的。Pubmed数据库对当前优化抗生素治疗持续时间的循证建议进行了审查。结果2020年1月收治98例患者;63例患者符合研究纳入标准,其中40例为男性。平均年龄74岁(18 ~ 92岁),平均住院天数3.4天(1 ~ 11天)。11例(17.5%)患者因感染过程在次月就诊急诊科或全科,其中7例再次入院。36例(57%)患者在研究前3个月内服用过抗生素。最常见的疾病是社区获得性肺炎(CAP) 16例(25.4%),急性支气管炎(AB) 15例(23.8%),COPD加重13例(20.6%)和流感7例(11.1%)。最常见的抗菌素处方是:头孢菌素24(26.7%)、复方阿莫昔洛夫20(22.2%)和喹诺酮类药物17(18.9%)。没有分析AB患者,因为在目前的科学证据中没有推荐的抗生素治疗的最佳持续时间。对其余患者进行分析(48例):35例使用抗生素的天数超过推荐证据(CAP 15例,COPD加重12例,流感4例,其他感染4例);9例患者按推荐疗程给予抗生素治疗(急性肾盂肾炎3例、流感3例、CAP 1例、医院获得性肺炎1例、并发性膀胱炎1例);4例用药时间短于推荐时间(1例并发膀胱炎、1例COPD加重、1例咽扁桃体炎、1例急性胃肠炎)。结论和相关性近75%的患者的抗生素疗程比推荐的证据更长。这应该是干预的优先事项。重要的是要提高对抗生素的认识,就合理使用抗生素而言,“越短越好”是“处方者的口头禅”。参考文献和/或致谢利益冲突无利益冲突
本文章由计算机程序翻译,如有差异,请以英文原文为准。
4CPS-245 Duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit
Background and importance Shortening the duration of antibiotic treatment is one of the cornerstones to reduce antibiotic pressure and, therefore, the appearance of antimicrobial resistance Aim and objectives To describe the duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit and to analyse the duration of antibiotic treatment with regards to the current evidence based recommendations. Material and methods A descriptive, retrospective, cross sectional study was carried out in a short stay hospitalisation unit in January 2020. Patients ≥14 years old with an antibiotic prescription at discharge were included. Data collected were: age, gender, average number of admission days, antibiotic prescribed and antibiotic clinical indication. Data were collected from patients’ electronic health records. Pubmed database review was performed regarding the current evidence based recommendations for optimising the duration of antibiotic treatment. Results 98 patients were admitted in January 2020; 63 patients met the study inclusion criteria and 40 were men. Average age was 74 years (18–92) and average number of admission days was 3.4 (1–11). 11 (17.5%) patients visited the emergency department or general practice the following month due to an infectious process and 7 of these patients were readmitted. 36 (57%) patients had taken antibiotics within 3 months before the study. The most common illnesses were community acquired pneumonia (CAP) 16 (25.4%), acute bronchitis (AB) 15 (23.8%), COPD exacerbation 13 (20.6%) and influenza 7 (11.1%). The most common antimicrobials prescribed were: cephalosporins 24 (26.7%), co-amoxiclav 20 (22.2%) and quinolones 17 (18.9%). Patients with AB were not analysed because there is no optimal duration of antibiotic treatment recommended in the current scientific evidence. The remainder of the patients were analysed (48): 35 were given antibiotics for more days than the recommended evidence (15 CAP, 12 COPD exacerbation, 4 influenza, 4 other infections); 9 patients were given antibiotics as per the recommended duration (3 acute pyelonephritis, 3 influenza, 1 CAP, 1 hospital acquired pneumonia, 1 complicated cystitis); and 4 were given antibiotics for a shorter duration than recommended (1 complicated cystitis, 1 COPD exacerbation, 1 pharyngotonsillitis, 1 acute gastroenteritis). Conclusion and relevance Nearly 75% of patients had a longer antibiotic course than the recommended evidence. This should be a priority for intervention. It is important to create antibiotic awareness, where ‘shorter is better’ is a ‘prescriber mantra’ as far as the rational use of antibiotics is concerned. References and/or acknowledgements Conflict of interest No conflict of interest
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