社区获得性肺炎患者的经验性抗生素处方：我们在哪些方面可以改进？
Empiric antibiotic prescribing for patients with community-acquired pneumonia: where can we improve?
作者信息
Buising K L, Thursky K A, Black J F, Macgregor L, Street A C, Kennedy M P, Brown G V
机构信息
Victorian Infectious Diseases Service, The Royal melbourne Hospital, Melbourne, Victoria, Australia.
出版信息
Intern Med J. 2008 Mar;38(3):174-7. doi: 10.1111/j.1445-5994.2007.01455.x.
BACKGROUND
Community acquired pneumonia is one of the most common infections for which antibiotics are prescribed in Australia.
METHODS
We audited empiric antibiotic prescribing for 392 adults with community-acquired pneumonia.
RESULTS
Only 61.9% of patients received empiric antibiotic coverage for both typical and atypical pathogens. Of those who required intensive care unit management, 34.6% did not receive antibiotic cover for atypical pneumonia pathogens within the first 24 h. Approximately 21.9% of patients reporting antibiotic allergies were given antibiotics to which they had a documented allergy.
CONCLUSION
Efforts to improve prescribing practices could be focused towards identifying patients with severe illness early and improving recognition of documented allergies.
背景
社区获得性肺炎是澳大利亚最常使用抗生素治疗的感染性疾病之一。
方法
我们审核了392例社区获得性肺炎成人患者的经验性抗生素处方。
结果
仅61.9%的患者接受了针对典型和非典型病原体的经验性抗生素覆盖。在需要重症监护病房管理的患者中，34.6%在最初24小时内未接受针对非典型肺炎病原体的抗生素覆盖。报告有抗生素过敏的患者中，约21.9%接受了有记录过敏的抗生素治疗。
结论
改善处方实践的努力可集中于早期识别重症患者并提高对有记录过敏的识别。
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