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法国教学医院传染病科抗生素相关不良事件:一项前瞻性研究。

Antibiotics-related adverse events in the infectious diseases department of a French teaching hospital: a prospective study.

机构信息

Service d'Infectiologie, CHU de Nice, Nice, France,

出版信息

Eur J Clin Microbiol Infect Dis. 2013 Dec;32(12):1611-6. doi: 10.1007/s10096-013-1920-y. Epub 2013 Jul 23.

DOI:10.1007/s10096-013-1920-y
PMID:23877571
Abstract

Antibiotics are a significant cause of adverse events (AE), but few studies have focused on prescriptions in hospitalized patients. In infectious diseases departments, the high frequency and diversity of antibiotics prescribed makes AE post-marketing monitoring easier. The aim of our study was to assess the incidence and type of AE in the infectious diseases department of a French teaching tertiary-care hospital. The main characteristics of each hospitalization, including all antibiotics prescribed and any significant AE were recorded prospectively in the medical dashboard of the department. We included all patients having suffered an AE due to systemic antibiotics between January 2008 and March 2011. Among the 3963 hospitalized patients, 2682 (68%) received an antibiotic and 151/2682 (5.6%) suffered an AE. Fifty-two (34%) AE were gastrointestinal disorders, 32 (21%) dermatological, 20 (13%) hepatobiliary, 16 (11%) renal and urinary disorders, 13 (9%) neurological and 11 (7%) blood disorders. Rifampin, fosfomycin, cotrimoxazole and linezolid were the leading causes of AE. Sixty-two percent of the antibiotics causing an AE were stopped and 38% were continued (including 11% with a dose modification). Patients suffering from AE had an increased length of stay (18 vs 10 days, P < 0.001). Our data could help choosing the safest antibiotic when several options are possible.

摘要

抗生素是不良事件(AE)的重要原因,但很少有研究关注住院患者的处方。在传染病科,由于抗生素的使用频率高且种类繁多,使得上市后监测 AE 变得更容易。我们研究的目的是评估法国一家教学型三级保健医院传染病科的 AE 发生率和类型。每个住院患者的主要特征,包括所有开具的抗生素和任何重要的 AE,都前瞻性地记录在该科的医疗仪表板中。我们纳入了 2008 年 1 月至 2011 年 3 月期间因全身使用抗生素而发生 AE 的所有患者。在 3963 名住院患者中,2682 名(68%)接受了抗生素治疗,151/2682(5.6%)发生了 AE。52 例(34%)AE 为胃肠道疾病,32 例(21%)为皮肤病,20 例(13%)为肝胆疾病,16 例(11%)为肾和泌尿系统疾病,13 例(9%)为神经系统疾病,11 例(7%)为血液系统疾病。利福平、磷霉素、复方磺胺甲噁唑和利奈唑胺是导致 AE 的主要原因。导致 AE 的抗生素中有 62%被停用,38%继续使用(包括 11%剂量调整)。发生 AE 的患者住院时间延长(18 天 vs 10 天,P<0.001)。我们的数据可以帮助在有多种选择时选择最安全的抗生素。

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