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安博大学转诊医院对社区获得性肺炎评估指南及经验性抗生素推荐的遵循情况:前瞻性观察研究

Adherence to Guidelines for Assessment and Empiric Antibiotics Recommendations for Community-Acquired Pneumonia at Ambo University Referral Hospital: Prospective Observational Study.

作者信息

Eticha Endalkachew Mekonnen, Gemechu Workineh Diriba

机构信息

Ambo University, College of Medicine and Health Science, School of Pharmacy, Ambo, Ethiopia.

Jigjiga University, College of Medicine and Health Science, School of Medicine, Jigjiga, Ethiopia.

出版信息

Patient Prefer Adherence. 2021 Feb 25;15:467-473. doi: 10.2147/PPA.S295118. eCollection 2021.

Abstract

OBJECTIVE

The high incidence and substantial morbidity and mortality associated with community-acquired pneumonia necessitate an accurate assessment and appropriate management of patients. This observational prospective study aimed to evaluate the physicians' adherence to the Ethiopian Standard Treatment Guideline for assessment and an empiric antibiotic selection for Community-acquired pneumonia.

RESULTS

The study indicated that the pneumonia severity assessment tool, CURB-65 score, was never used. Of 141 patients referred to an admitting diagnosis of severe community-acquired pneumonia, only 50 were subsequently found to satisfy the guideline criteria, over-diagnosis of 41.9%. Large proportions of the participants (130, 60%) were prescribed antibiotics in the last three months. The most commonly prescribed single antibiotic was Ceftriaxone (47, 21.7%), while ceftriaxone plus azithromycin was the most common combination, 110 (50.7%). In general, the extent of non-adherence to the national guideline for the use of antibiotics was 36.4%. In conclusion, the use of CRB65 scores was uncommon in the study setting. Poor adherence to Ethiopian Standard Treatment Guideline regarding the decision of hospital admission (41.9%) and the antimicrobial selection (36.4%) was determined.

摘要

目的

社区获得性肺炎的高发病率以及较高的发病率和死亡率使得对患者进行准确评估和适当管理成为必要。这项观察性前瞻性研究旨在评估医生对埃塞俄比亚社区获得性肺炎评估和经验性抗生素选择标准治疗指南的遵循情况。

结果

研究表明,从未使用过肺炎严重程度评估工具CURB - 65评分。在141例被转诊诊断为严重社区获得性肺炎的患者中,仅有50例随后被发现符合指南标准,过度诊断率为41.9%。很大比例的参与者(130例,60%)在过去三个月内使用过抗生素。最常开具的单一抗生素是头孢曲松(47例,21.7%),而头孢曲松加阿奇霉素是最常见的联合用药,共110例(50.7%)。总体而言,抗生素使用不遵循国家指南的程度为36.4%。总之,在研究环境中使用CRB65评分并不常见。确定在医院入院决策(41.9%)和抗菌药物选择(36.4%)方面对埃塞俄比亚标准治疗指南的遵循情况较差。

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