Alemkere Getachew, Gilagil Getu, Gebrehiwot Teklu, Tilahun Zelalem, Mengist Hylemariam Mihiretie
Department of Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Res Notes. 2018 Sep 21;11(1):675. doi: 10.1186/s13104-018-3782-y.
The main aim of the study was to assess physicians' utilization of microbiologic reports and determinants of their preference in ordering microbiologic culture among patients with systemic bacterial infection at Tikur Anbessa Specialized Hospital.
Of the total 369 patients observed, 91 (24.7%) had microbiologic reports (culture and gram stain). About 12% of the patients had culture reports of which majority (77.8%) were available after 72 h of the initial antibiotic start. Antimicrobial susceptibility test was done for 83.3% of the positive cultures. Although 99.5% of the patients were initially placed on empiric therapy, adjustment was done in 114 (30.9%) of the patients. Among these patients with adjusted therapy, changes were unrelated to microbiologic reasons in 103 (90.4%) patients. None of these changes were for the reason of streamlining therapy. Prolonged hospital stay (AOR = 2.9, 95% CI 1.2-6.7), senior physician consultation (AOR = 4.1, 95% CI 1.1-17.7) and suspicion of new site of infection (AOR = 2.6, 95% CI 1.1-6.2) were positive independent predictors for physicians' preference in ordering culture.
本研究的主要目的是评估提库尔安贝萨专科医院系统性细菌感染患者中医生对微生物学报告的利用情况及其在开具微生物培养医嘱时的偏好决定因素。
在总共观察的369例患者中,91例(24.7%)有微生物学报告(培养和革兰氏染色)。约12%的患者有培养报告,其中大多数(77.8%)在开始使用初始抗生素72小时后获得。对83.3%的阳性培养物进行了药敏试验。虽然99.5%的患者最初接受经验性治疗,但114例(30.9%)患者进行了调整。在这些接受调整治疗的患者中,103例(90.4%)患者的治疗改变与微生物学原因无关。这些改变均不是为了简化治疗。住院时间延长(比值比=2.9,95%置信区间1.2 - 6.7)、上级医师会诊(比值比=4.1,95%置信区间1.1 - 17.7)和怀疑新的感染部位(比值比=2.6,95%置信区间1.1 - 6.)是医生开具培养医嘱偏好的阳性独立预测因素。