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脓毒症患者的抗生素耐药性:抗生素使用的评估与建议

Antibiotic resistance in sepsis patients: evaluation and recommendation of antibiotic use.

作者信息

Pradipta Ivan Surya, Sodik Dian Chairunnisa, Lestari Keri, Parwati Ida, Halimah Eli, Diantini Ajeng, Abdulah Rizky

机构信息

Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.

出版信息

N Am J Med Sci. 2013 Jun;5(6):344-52. doi: 10.4103/1947-2714.114165.

Abstract

BACKGROUND

The appropriate selection of empirical antibiotics based on the pattern of local antibiotic resistance can reduce the mortality rate and increase the rational use of antibiotics.

AIMS

We analyze the pattern of antibiotic use and the sensitivity patterns of antibiotics to support the rational use of antibiotics in patients with sepsis.

MATERIALS AND METHODS

A retrospective observational study was conducted in adult sepsis patient at one of Indonesian hospital during January-December 2011. Data were collected from the hospital medical record department. Descriptive analysis was used in the processing and interpretation of data.

RESULTS

A total of 76 patients were included as research subjects. Lung infection was the highest source of infection. In the 66.3% of clinical specimens that were culture positive for microbes, Klebsiella pneumoniae, Escherichia coli, Staphylococcus hominis were detected with the highest frequency. The six most frequently used antibiotics, levofloxacin, ceftazidime, ciprofloxacin, cefotaxime, ceftriaxone, and erythromycin, showed an average resistance above 50%.

CONCLUSIONS

The high use of antibiotic with a high level resistance requires a policy to support its rational use. Local microbial pattern based on site infection and pattern of antibiotics sensitivity test can be used as supporting data to optimize appropriateness of empirical antibiotics therapy in sepsis patients.

摘要

背景

根据当地抗生素耐药模式合理选择经验性抗生素可降低死亡率并提高抗生素的合理使用。

目的

我们分析抗生素使用模式和抗生素敏感性模式,以支持脓毒症患者抗生素的合理使用。

材料与方法

2011年1月至12月期间,在印度尼西亚一家医院对成年脓毒症患者进行了一项回顾性观察研究。数据从医院病历部门收集。采用描述性分析进行数据处理和解释。

结果

共纳入76例患者作为研究对象。肺部感染是最高的感染源。在66.3%微生物培养阳性的临床标本中,肺炎克雷伯菌、大肠埃希菌、人葡萄球菌检出频率最高。六种最常用的抗生素,左氧氟沙星、头孢他啶、环丙沙星、头孢噻肟、头孢曲松和红霉素,平均耐药率超过50%。

结论

高耐药性抗生素的大量使用需要政策支持其合理使用。基于感染部位的当地微生物模式和抗生素敏感性试验模式可作为支持数据,以优化脓毒症患者经验性抗生素治疗的合理性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73ee/3731864/7ba6849eebc6/NAJMS-5-344-g004.jpg

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