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[急诊科诊断的社区获得性肺炎中首次使用抗生素的时间]

[Time to first antibiotic dose in community-acquired pneumonia diagnosed in an emergency department].

作者信息

Romero Pizarro Y, Bascuñana Morejón de Girón J, Vicuña Andrés I, Maínez Saiz C, Criado Dabrowska C, Moya Mir M S

机构信息

Servicio de Urgencias, Hospital Universitario Puerta de Hierro, Madrid, Spain.

出版信息

Rev Clin Esp. 2009 Oct;209(9):409-14. doi: 10.1016/s0014-2565(09)72512-3.

Abstract

BACKGROUND

Early antibiotic administration to patients diagnosed of community-acquired pneumonia (CAP) has been associated with a lower mortality. In the USA, its administration within four hours has been implanted as a quality standard. The objective of this work was to analyze, in a Spanish emergency department, the performance with patients with CAP, focusing on the administration of the first dose of antibiotic.

PATIENTS AND METHOD

Clinics, welfare and organizational aspects have been analysed on 93 patients diagnosed of CAP in an emergency department in order to identify their influence on antibiotic administration within 4 hours.

RESULTS

46.2% of patients received antibiotics within 4 hours. The fact that patients were assisted in the higher complexity level showed a positive association with the antibiotic administration within 4 hours. On the contrary, presence of more than 10 patients waiting to be admitted showed a negative association.

CONCLUSIONS

Early antibiotic administration in the CAP is possible. On order to guarantee a higher number of patients taking antibiotics within 4 hours we have to improve quality of care in both the emergency department (to guarantee correct classification according to the level of complexity) and in the hospital (management of beds to avoid delay in the admission of the patients).

摘要

背景

对诊断为社区获得性肺炎(CAP)的患者早期使用抗生素与较低的死亡率相关。在美国,在4小时内使用抗生素已被确立为一项质量标准。这项研究的目的是在一家西班牙急诊科分析CAP患者的治疗情况,重点关注首剂抗生素的使用。

患者与方法

对一家急诊科93例诊断为CAP的患者的临床、福利及组织方面进行了分析,以确定它们对4小时内使用抗生素的影响。

结果

46.2%的患者在4小时内接受了抗生素治疗。患者在较高复杂程度级别接受诊治这一情况与4小时内使用抗生素呈正相关。相反,有超过10名患者等待入院则呈负相关。

结论

在CAP患者中早期使用抗生素是可行的。为确保更多患者在4小时内使用抗生素,我们必须提高急诊科(确保根据复杂程度进行正确分类)和医院(床位管理以避免患者入院延迟)的医疗质量。

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