Veterans Affairs Medical Center, Infectious Diseases Research Program, Providence, RI; Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI.
Veterans Affairs Medical Center, Infectious Diseases Research Program, Providence, RI; Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI; Warren Alpert Medical School of Brown University, Providence, RI.
J Am Med Dir Assoc. 2018 Sep;19(9):744-747. doi: 10.1016/j.jamda.2018.05.006. Epub 2018 Jun 19.
Antibiograms are important clinical tools to report and track antibiotic susceptibility and help guide empiric antimicrobial therapy. Antibiograms support compliance with antimicrobial stewardship (AMS) requirements from the Centers for Medicare and Medicaid Services and are in line with recommendations from the Centers for Disease Control and Prevention Core Elements of AMS for nursing homes/long-term care facilities (LTCFs). Unlike most acute-care settings, LTCFs are challenged in creating antibiograms because of the low number of bacterial isolates collected annually. Determining the best methodology for creating clinically useful antibiograms for LTCFs needs to be explored. Possible approaches include (1) extending the isolate data beyond 1 year, (2) combining isolate data from the same geographic region, (3) using a nearby acute-care facility's antibiogram as a proxy, or (4) collapsing isolate data. This article discusses the benefits and limitations of each approach.
抗生素药敏谱是报告和跟踪抗生素敏感性的重要临床工具，有助于指导经验性抗菌治疗。抗生素药敏谱支持医疗保险和医疗补助服务中心（Centers for Medicare and Medicaid Services）对抗菌药物管理（Antimicrobial Stewardship，AMS）要求的合规性，并且符合疾病控制与预防中心（Centers for Disease Control and Prevention）针对疗养院/长期护理机构（Nursing Homes/Long-term Care Facilities，LTCFs）的 AMS 核心要素的建议。与大多数急性护理环境不同，由于每年收集的细菌分离物数量较少，疗养院在创建抗生素药敏谱方面面临挑战。需要探索为疗养院创建具有临床意义的抗生素药敏谱的最佳方法。可能的方法包括：(1) 将分离物数据扩展到 1 年以上；(2) 合并来自同一地理区域的分离物数据；(3) 使用附近急性护理机构的抗生素药敏谱作为替代；或 (4) 合并分离物数据。本文讨论了每种方法的优缺点。
