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2004 年至 2013 年韩国一家三级保健医院抗生素使用的十年趋势。

Ten-year trends in antibiotic usage at a tertiary care hospital in Korea, 2004 to 2013.

机构信息

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.

出版信息

Korean J Intern Med. 2020 May;35(3):703-713. doi: 10.3904/kjim.2017.332. Epub 2018 Sep 27.

Abstract

BACKGROUND/AIMS: This study was performed to evaluate trends in antibiotic usage at a tertiary care hospital in Korea.

METHODS

This study collated antibiotic prescription data and total patient days for inpatients at a tertiary care hospital in Korea between 2004 and 2013. The consumption of each class of antibiotic was converted to defined daily dose (DDD)/1,000 patient-days. We defined 3rd generation cephalosporins, 4th generation cephalosporins, β-lactam/β-lactamase inhibitors, and fluoroquinolones as broad-spectrum antibiotics; carbapenems, tigecycline, glycopeptides, oxazolidinone, and polymyxin were defined as antibiotics against multidrug-resistant (MDR) pathogens. Other antibiotic classes were defined as nonbroad-spectrum antibiotics.

RESULTS

Mean antibiotic consumption was 920.69 DDD/1,000 patient-days. The proportions of broad-spectrum antibiotics, antibiotics against MDR pathogens, and nonbroad-spectrum antibiotics were 41.8% (384.48/920.69), 3.5% (32.24/920.69), and 54.7% (503.97/920.69), respectively. Consumption of broad-spectrum antibiotics (coefficient for time 0.141; p = 0.049) and antibiotics against MDR pathogens (coefficient for time 0.185; p < 0.001) showed a significant increasing trend over the study period. Nonbroad-spectrum antibiotic consumption showed a significant decreasing trend over the study period (coefficient for time -2.601; p < 0.001).

CONCLUSION

Over the 10-year period, a stepwise increase in the consumption of broad-spectrum antibiotics and antibiotics against MDR pathogens was observed at a tertiary care hospital in Korea. Conversely, during the same period, nonbroad-spectrum antibiotic consumption showed a significant decreasing trend.

摘要

背景/目的:本研究旨在评估韩国一家三级保健医院抗生素使用趋势。

方法

本研究收集了韩国一家三级保健医院 2004 年至 2013 年住院患者的抗生素处方数据和总患者天数。将每种抗生素的用量转换为限定日剂量(DDD)/1000 患者日。我们将第三代头孢菌素、第四代头孢菌素、β-内酰胺/β-内酰胺酶抑制剂和氟喹诺酮类定义为广谱抗生素;碳青霉烯类、替加环素、糖肽类、恶唑烷酮类和多粘菌素类定义为抗多重耐药(MDR)病原体的抗生素。其他抗生素类别被定义为非广谱抗生素。

结果

平均抗生素用量为 920.69 DDD/1000 患者日。广谱抗生素、抗 MDR 病原体抗生素和非广谱抗生素的比例分别为 41.8%(384.48/920.69)、3.5%(32.24/920.69)和 54.7%(503.97/920.69)。广谱抗生素(时间系数 0.141;p = 0.049)和抗 MDR 病原体抗生素(时间系数 0.185;p < 0.001)的消耗呈显著增加趋势。研究期间,非广谱抗生素消耗呈显著下降趋势(时间系数-2.601;p < 0.001)。

结论

在 10 年期间,韩国一家三级保健医院广谱抗生素和抗 MDR 病原体抗生素的使用呈逐步上升趋势。相反,在同一时期,非广谱抗生素的消耗呈显著下降趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6012/7214379/aa11ab49c11b/kjim-2017-332f1.jpg

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