Suphansatit Ronnawich, Uitrakul Suriyon
Department of Pharmacy, Phang-Nga Hospital, Thai Chang, Phang Nga, Thailand.
Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Thasala, Nakhon Si Thammarat, Thailand.
Infect Drug Resist. 2020 Dec 17;13:4495-4500. doi: 10.2147/IDR.S285261. eCollection 2020.
This retrospective pilot study aimed to investigate the antibiotic regimens used to treat infections at a secondary hospital in southern Thailand. Additionally, the clinical outcomes and mortality of each regimen are described.
The medical charts of all patients admitted to Phang-Nga Hospital, Thailand, between 1 January 2019 and 31 May 2020 due to infection were reviewed. Data were collected on the antibiotics that patients received before and after sensitivity testing, along with the clinical cure, mortality rates, and nephrotoxicity.
Of the 32 inpatients recruited in the study, the most prescribed antibiotic regimen for empirical therapy was beta-lactam/beta-lactamase inhibitor monotherapy (22%), and for definitive therapy was meropenem monotherapy (28%). Combination therapy with two, three, or four antibiotics was prescribed less than 50% of cases for both empirical and definitive therapy. Moreover, the results indicated that patients receiving combination therapy had a lower clinical response and higher mortality than those receiving monotherapy. Furthermore, regimens containing colistin did not provide a higher clinical cure compared to those without colistin.
The results of this pilot study support the use of monotherapy antibiotic regimens, including ceftazidime and meropenem, for the treatment of infections in secondary hospitals. However, as these results are from a single hospital with limited number of patients, the application of the results should be done carefully. More patient data from other hospitals will be collected in the next phase of this study.
本回顾性试点研究旨在调查泰国南部一家二级医院用于治疗感染的抗生素方案。此外,还描述了每种方案的临床结局和死亡率。
回顾了2019年1月1日至2020年5月31日期间因感染入住泰国攀牙医院的所有患者的病历。收集患者在药敏试验前后接受的抗生素数据,以及临床治愈率、死亡率和肾毒性。
在该研究招募的32名住院患者中,经验性治疗最常用的抗生素方案是β-内酰胺/β-内酰胺酶抑制剂单药治疗(22%),确定性治疗是美罗培南单药治疗(28%)。经验性治疗和确定性治疗使用两种、三种或四种抗生素联合治疗的病例均不到50%。此外,结果表明,接受联合治疗的患者临床反应较低,死亡率高于接受单药治疗的患者。此外,与不含黏菌素的方案相比,含黏菌素的方案并未提供更高的临床治愈率。
这项试点研究的结果支持在二级医院使用包括头孢他啶和美罗培南在内的单药抗生素方案治疗感染。然而,由于这些结果来自一家患者数量有限的单一医院,结果的应用应谨慎进行。本研究的下一阶段将收集来自其他医院的更多患者数据。