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血液病患者的抗生素耐药状况及其成本:一项为期两年的分析。

Antibiotic resistance status and its costs in hematological patients: A two-year analysis.

作者信息

Gedik Habip

机构信息

Department of Infectious Diseases and Clinical MicrobiologyMinistry of Health Okmeydanı Training and Research Hospitalstanbul, Turkey.

出版信息

Caspian J Intern Med. 2017 Fall;8(4):276-281. doi: 10.22088/cjim.8.4.276.

Abstract

BACKGROUND

Most frequently, empirical antibiotic therapy is immediately administered for patients with febrile neutropenia (FN). In this study, its aim was to assess the antibiotic resistance status and the cost of antibacterial agents in FN patients associated with hematological malignancies.

METHODS

The cost of antibacterial agents used in FN episodes in patients with hematologic neoplasms followed-up at the Department of Hematology from November 2010 to November 2012 were analyzed retrospectively.

RESULTS

In the study period, 15 of 141 patients who were admitted to the hematology ward and ineligible for the study criteria were excluded. In total, 282 febrile episodes of 126 consecutive patients with neutropenia were retrospectively investigated. Imipenem was found to be the most commonly used among the antibacterial drugs as 1.16 patient daily dose (PDD)/100 patient-days, 117.16 is the mean defined daily dose (DDD) per month and US $73264.66 total cost per year, followed by meropenem, cefoperazone-sulbactam, and linezolid.

CONCLUSION

Choosing noncarbapenem-based antibacterial therapy for empirical treatment of FN until the growth of microorganisms and switching to carbapenem therapy subsequent to new radiological, or microbiological, or/ and clinical findings, the appropriate vancomycin use may decrease the cost of antibacterial agents in the treatment of FN episodes in patients with hematologic malignancies contributing to antimicrobial stewardship.

摘要

背景

对于发热性中性粒细胞减少症(FN)患者,最常见的做法是立即给予经验性抗生素治疗。本研究旨在评估血液系统恶性肿瘤相关FN患者的抗生素耐药状况及抗菌药物成本。

方法

回顾性分析2010年11月至2012年11月在血液科随访的血液系统肿瘤患者FN发作时使用抗菌药物的成本。

结果

在研究期间,141名入住血液科病房但不符合研究标准的患者中有15名被排除。总共对126例连续性中性粒细胞减少患者的282次发热发作进行了回顾性调查。发现亚胺培南是抗菌药物中最常用的,为1.16患者每日剂量(PDD)/100患者日,每月平均限定日剂量(DDD)为117.16,每年总成本为73264.66美元,其次是美罗培南、头孢哌酮-舒巴坦和利奈唑胺。

结论

在微生物生长之前,选择非碳青霉烯类抗菌药物进行FN的经验性治疗,在有新的影像学、微生物学和/或临床发现后改用碳青霉烯类治疗,合理使用万古霉素可能会降低血液系统恶性肿瘤患者FN发作治疗中抗菌药物的成本,有助于抗菌药物管理。

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