Tayside Respiratory Research Group, University of Dundee and Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
J Antimicrob Chemother. 2014 Feb;69(2):515-8. doi: 10.1093/jac/dkt362. Epub 2013 Sep 10.
Prolonged antibiotic courses are common in patients with lower respiratory tract infections (LRTIs) and contribute to antibiotic resistance and side effects. This study describes a multidisciplinary intervention to reduce antibiotic duration in LRTI patients.
This was a prospective before-and-after intervention study conducted from November 2011 to December 2012. Antibiotic duration was recorded for 6 months for all LRTI admissions (pneumonia, exacerbation of chronic obstructive pulmonary disease, exacerbation of asthma, and other LRTIs), followed by the introduction of an intervention intended to reduce the duration of antibiotic treatment. The intervention incorporated an antibiotic duration based on the CURB65 score, automatic stop dates and pharmacist feedback to prescribers.
Two hundred and eighty-one patients were included in the pre-intervention group and 221 in the post-intervention group. The intervention resulted in a reduction in the duration of antibiotic treatment from 8.3 to 6.8 days (P < 0.001, 18.1% relative reduction). The rate of antibiotic-related adverse effects reduced from 31% to 19% (P = 0.03, 39.3% relative reduction). There was no increase in mortality or length of stay
A simple intervention can significantly reduce antibiotic duration and antibiotic-related side effects.
下呼吸道感染（LRTIs）患者常接受长时间的抗生素治疗，这会导致抗生素耐药性和副作用的产生。本研究描述了一种多学科干预措施，以减少 LRTI 患者的抗生素疗程。
这是一项从 2011 年 11 月至 2012 年 12 月进行的前瞻性前后干预研究。对所有 LRTI 入院患者（肺炎、慢性阻塞性肺疾病恶化、哮喘恶化和其他 LRTIs）进行了 6 个月的抗生素疗程记录，随后引入了旨在缩短抗生素治疗时间的干预措施。该干预措施结合了基于 CURB65 评分的抗生素疗程、自动停药日期和药剂师对处方医生的反馈。
共有 281 名患者纳入了干预前组，221 名患者纳入了干预后组。干预后，抗生素治疗的持续时间从 8.3 天缩短至 6.8 天（P<0.001，相对减少 18.1%）。抗生素相关不良反应的发生率从 31%降至 19%（P=0.03，相对减少 39.3%）。死亡率或住院时间没有增加。
一项简单的干预措施可显著缩短抗生素疗程和抗生素相关的副作用。
