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[法国一家教学医院抗生素(氟喹诺酮类、氨基糖苷类和阿莫西林-克拉维酸)处方的质量]

[Quality of antibiotic (fluoroquinolons, aminosids and amoxicillin-clavulanic acid) prescription in a French teaching hospital].

作者信息

Mechkour S, Vinat A, Yilmaz M, Faure K, Grandbastien B

机构信息

Équipe opérationnelle d'hygiène, hôpitaux universitaire de Strasbourg, 1, place de l'hôpital, 67091 Strasbourg cedex, France.

出版信息

Pathol Biol (Paris). 2011 Feb;59(1):9-15. doi: 10.1016/j.patbio.2010.07.017.

Abstract

OBJECTIVES

To assess the quality of prescription of fluoroquinolons, aminosids and amoxicillin-clavulanic acids in medicine departments.

METHODS

Data on target antibiotic prescription were collected on a given day and confronted to local recommendations and literature guidelines. Evaluation of antibiotic therapy was done by assessing molecule choice, administration conditions (dosages, route and administration schedule, treatment duration), reassessment of treatments 48-72 h later, dose adaptation of aminosids depending on serum monitoring.

RESULTS

Sixty-three patients were included and 67 "target" antibiotics were prescribed. Prevalence of antibiotic-treated patients was 24.4%, and 14.6% for "target" antibiotic-treated patients. Antibiotic choice was appropriate in 67% of prescriptions. Dosages were adequates in 94% of case and administration schedule in 97% of cases. The oral route administration as soon as possible was applied to half of patients. Treatment duration were respected for 94% of prescriptions. Reassessment of antibiotic therapy 48-72 h later was realized in 66% of cases. Dose adaptation of aminosids, when necessary, was realized on one third of cases. For all the quality criteria assessed, the overall frequency of prescription conformity was 44%.

CONCLUSION

Large diffusion of protocols, systematic reassessment of treatments at 48-72 h, promotion of training sessions for new prescribers in the institution, reinforcing the function of medical correspondents in antibiotic therapy and infectiologists, periodic evaluation of antibiotic therapy, should improve the quality of antibiotic therapy.

摘要

目的

评估药学部门氟喹诺酮类、氨基糖苷类和阿莫西林-克拉维酸的处方质量。

方法

在特定日期收集目标抗生素处方数据,并与当地建议和文献指南进行对照。通过评估药物选择、给药条件(剂量、途径和给药时间表、治疗持续时间)、48 - 72小时后对治疗的重新评估以及根据血清监测调整氨基糖苷类药物剂量来对抗生素治疗进行评估。

结果

纳入63例患者,开具了67种“目标”抗生素。接受抗生素治疗的患者患病率为24.4%,接受“目标”抗生素治疗的患者为14.6%。67%的处方中抗生素选择恰当。94%的病例剂量合适,97%的病例给药时间表合适。一半的患者尽快采用口服途径给药。94%的处方遵守了治疗持续时间。66%的病例在48 - 72小时后对抗生素治疗进行了重新评估。必要时,三分之一的病例实现了氨基糖苷类药物的剂量调整。对于所有评估的质量标准,处方符合率的总体频率为44%。

结论

广泛传播方案、在48 - 72小时对治疗进行系统重新评估、促进对机构中新开处方者的培训课程、加强医学通讯员在抗生素治疗和感染病专家方面的作用、定期对抗生素治疗进行评估,应能提高抗生素治疗质量。

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