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在阿曼一家三级护理医院评估美罗培南处方的适宜性:一项回顾性研究。

Evaluation of the appropriateness of meropenem prescribing at a tertiary care hospital: A retrospective study in Oman.

机构信息

Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Muscat, Sultanate of Oman.

Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.

出版信息

Int J Infect Dis. 2020 Jul;96:180-186. doi: 10.1016/j.ijid.2020.04.045. Epub 2020 Apr 24.

DOI:10.1016/j.ijid.2020.04.045
PMID:32339716
Abstract

OBJECTIVES

The aim of this study was to evaluate the use of meropenem in terms of indication and continuation of treatment at Sultan Qaboos University Hospital (SQUH), Muscat, Oman.

METHODS

A retrospective observational study, conducted by reviewing the medical records of 400 adults, admitted patients who received at least one dose of meropenem during the study period (January 2017 to September 2017). The analysis was performed using univariate statistics.

RESULTS

Meropenem was prescribed empirically in 382/400 (96%) of the cases. The majority (315/361 (87%)) of the patients received the proper meropenem dose. The indication for meropenem was considered appropriate in only 196/400 (49%) of the cases. The continuation of treatment was evaluated according to culture and sensitivity results in 202 cases, out of which 112 (55%) were justified. Most of the inappropriate uses were seen in oncology and hematology cases (31/42 (74%) and 61/101 (60%), respectively) and among respiratory and urinary tract infections (126/155 (81%) and 40/46 (87%), respectively).

CONCLUSIONS

Approximately half of the meropenem orders at SQUH in Oman were inappropriate and unjustified by culture-test results. New strategies are needed to optimize the rational use of meropenem and to ensure appropriate de-escalation and discontinuation of meropenem whenever indicated.

摘要

目的

本研究旨在评估在阿曼苏尔坦·卡布斯大学医院(SQUH)使用美罗培南的情况,包括用药指征和治疗持续时间。

方法

这是一项回顾性观察性研究,通过查阅 400 名成年住院患者的病历,对 2017 年 1 月至 9 月期间至少使用过一次美罗培南的患者进行分析。采用单变量统计分析。

结果

在 400 例患者中,382 例(96%)经验性使用了美罗培南。大多数患者(315/361,87%)接受了适当的美罗培南剂量。只有 196/400(49%)的病例的用药指征被认为是恰当的。根据 202 例患者的培养和药敏结果评估了治疗的持续时间,其中 112 例(55%)是合理的。在肿瘤和血液科病例(31/42,74%和 61/101,60%)和呼吸道及尿路感染病例(126/155,81%和 40/46,87%)中,不合理用药的情况更为常见。

结论

在阿曼 SQUH,大约一半的美罗培南医嘱与培养试验结果不符,没有用药指征。需要采取新的策略来优化美罗培南的合理使用,并确保在适当的时候进行降级和停药。

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