UnityPoint Health-Des Moines, Des Moines, IA.
UnityPoint Health-Des Moines, Des Moines, IA.
Am J Infect Control. 2017 Nov 1;45(11):1203-1207. doi: 10.1016/j.ajic.2017.05.013. Epub 2017 Jul 18.
Research on treating skin and soft tissue infections (SSTI) has shown improved patient outcomes with effective pharmaceutic prescribing. Antimicrobial stewardship programs can reduce consequences of broad-spectrum antimicrobial administration in SSTI treatment.
Prospective and historic control data were collected during two 7-month periods. Intervention consisted of implementing a new SSTI evidence-based treatment algorithm and provider education, including calls and medical record notes targeted at physicians.
Of 412 patients, 76 and 86 were found eligible from the historic and intervention groups, respectively. The intervention group had a higher prevalence of appropriate antibiotic usage (33% vs 19%, respectively; P = .04). There was a lower median number of days from intravenous antibiotic therapy to oral conversion (3 vs 5; P < .0001) and a lower median number of days of antipseudomonal antibiotic use (3 vs 5; P = .03) in the intervention group, respectively. The intervention group also had fewer documented SSTI treatment complications (1% vs 8%, respectively; P = .04). The positive outcomes outlined demonstrate potential impacts made from the use of multidisciplinary antibiotic stewardship initiatives.
Appropriate use of antimicrobial agents under the direction of an antimicrobial stewardship program can lead to improved outcomes for patients being treated for SSTIs.
针对皮肤软组织感染(SSTI)的研究表明,有效的药物处方可改善患者的治疗效果。抗菌药物管理计划可减少 SSTI 治疗中广谱抗菌药物管理的后果。
在两个为期 7 个月的时期内收集了前瞻性和历史性对照数据。干预措施包括实施新的 SSTI 循证治疗算法和针对医生的教育,包括电话和病历记录。
在 412 名患者中,分别从历史组和干预组中筛选出 76 名和 86 名符合条件的患者。干预组适当使用抗生素的比例更高(分别为 33%和 19%;P=0.04)。干预组从静脉用抗生素治疗转为口服治疗的中位数天数(3 天 vs 5 天;P<0.0001)和使用抗假单胞菌抗生素的中位数天数(3 天 vs 5 天;P=0.03)均较低。干预组的 SSTI 治疗并发症记录也较少(分别为 1%和 8%;P=0.04)。所概述的积极结果表明,多学科抗菌药物管理计划的使用可能对 SSTI 治疗患者的结果产生影响。
在抗菌药物管理计划的指导下合理使用抗菌药物,可以改善治疗皮肤软组织感染患者的治疗效果。