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[智利康塞普西翁地区医院限制使用抗生素的情况演变及细菌药敏趋势]

[Evolution of use of antibiotics of restricted prescription and trend of bacterial susceptibility in Concepcion Regional Hospital, Chile].

作者信息

Morales Felipe E, Villa Lorenzo A, Fernández Pola B, López Mariela A, Mella Sergio, Muñoz Maritza

机构信息

Departamento de Farmacia, Universidad de Concepción, Concepción, Chile.

出版信息

Rev Chilena Infectol. 2012 Oct;29(5):492-8. doi: 10.4067/S0716-10182012000600002.

Abstract

The aim of this study was analyze the use of restricted antibiotics by patients hospitalized between 2004 and 2008 in Guillermo Grant Benavente Hospital in Concepcion. Also we attempted to identify possible correlations between antibiotic consumption and patterns of bacterial susceptibility. We performed a retrospective observational study that quantified the use of restricted antibiotics using DDD/100-bed-days, and cumulative susceptibility reports informed by the hospital's microbiology laboratory for bacterial susceptibility. The consumption of restricted antibiotics significantly increased between 2004 and 2008 (35%, p = 0.005). The groups with largest use were glycopeptides (37%) and carbapenems (30 %). These results can be explained by the emergence of endemic Methicillin-resistant Staphylococcus aureus (MRSA) and of Extended-spectrum beta-lactamase (ESBL) Gram negative bacilli. Results showed a decrease in susceptibility of P. aeruginosa to imipenem (p = 0.038) and K. pneumoniae to ciprofloxacin (p = 0.021). The total consumption of restricted antibiotic has significantly increased, especially among complex medical services. A significant decrease in bacterial susceptibility has been observed mainly in gram-negative bacilli. The monitoring of antimicrobial prescribing practices and local susceptibility patterns are essential to promote the rational use of antibiotics.

摘要

本研究旨在分析2004年至2008年期间在康塞普西翁市吉列尔莫·格兰特·贝纳文特医院住院患者使用限制级抗生素的情况。我们还试图确定抗生素使用与细菌药敏模式之间可能存在的相关性。我们进行了一项回顾性观察研究,使用限定日剂量(DDD)/100床日来量化限制级抗生素的使用,并依据医院微生物实验室提供的细菌药敏累积报告进行分析。2004年至2008年期间,限制级抗生素的使用量显著增加(35%,p = 0.005)。使用量最大的类别是糖肽类(37%)和碳青霉烯类(30%)。这些结果可以用耐甲氧西林金黄色葡萄球菌(MRSA)和超广谱β-内酰胺酶(ESBL)革兰阴性杆菌的流行来解释。结果显示铜绿假单胞菌对亚胺培南的药敏性下降(p = 0.038),肺炎克雷伯菌对环丙沙星的药敏性下降(p = 0.021)。限制级抗生素的总使用量显著增加,尤其是在复杂医疗服务中。主要在革兰阴性杆菌中观察到细菌药敏性显著下降。对抗菌药物处方行为和当地药敏模式进行监测对于促进抗生素的合理使用至关重要。

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