Grasela T H, Welage L S, Walawander C A, Timm E G, Pelter M A, Poirier T I, Walters J K
School of Pharmacy, State University of New York, Buffalo 14260.
DICP. 1990 Dec;24(12):1220-5. doi: 10.1177/106002809002401215.
Antibiotic prescribing information was prospectively collected on 1822 hospitalized patients treated for suspected or documented bacterial pneumonia. Antibacterial therapy with a single antibiotic was employed in more than 50 percent of the patients, with cefazolin, cefuroxime, ampicillin, and ceftriaxone sodium representing the most commonly employed agents. Combination therapy using two antibiotics was employed in approximately 30 percent of patients with the aminoglycosides, particularly gentamicin, used extensively. A satisfactory outcome was achieved in approximately 80 percent of patients with a community- or institutional-acquired pneumonia; only 66 percent of nosocomial pneumonias had a satisfactory outcome. An important observation was the apparently common practice of switching patients to an oral antibiotic regimen after an average of seven days of antibiotics and subsequently discharging the patient. No difference was observed in the patterns of clinical response or duration of therapy for culture-positive versus culture-negative patients. The results of this surveillance program can serve as a basis for comparison of institution-specific drug utilization evaluation programs.
前瞻性收集了1822例因疑似或确诊细菌性肺炎而住院治疗的患者的抗生素处方信息。超过50%的患者采用单一抗生素进行抗菌治疗，其中头孢唑林、头孢呋辛、氨苄西林和头孢曲松钠是最常用的药物。约30%的患者采用两种抗生素联合治疗，氨基糖苷类药物，尤其是庆大霉素，被广泛使用。社区获得性或医院获得性肺炎患者中约80%取得了满意的治疗效果；医院内肺炎患者只有66%取得了满意的治疗效果。一个重要的观察结果是，明显常见的做法是在平均使用抗生素7天后将患者转为口服抗生素治疗方案，随后让患者出院。培养阳性与培养阴性患者的临床反应模式或治疗持续时间没有差异。该监测项目的结果可作为比较各机构特定药物利用评估项目的基础。
