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药剂师审核对肺炎和尿路感染抗生素使用疗程的影响。

Effect of Pharmacist Audit on Antibiotic Duration for Pneumonia and Urinary Tract Infection.

作者信息

Thomas Ashley A, Korienek Patrick J, Reid Stacy A, Dierkhising Ross A, Dababneh Ala S, Lessard Sarah R

机构信息

Pharmacy Services, Mayo Clinic Health System - Southwest Wisconsin Region, La Crosse.

Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 Jul 26;5(4):763-769. doi: 10.1016/j.mayocpiqo.2021.06.007. eCollection 2021 Aug.

Abstract

OBJECTIVE

To assess the effect of clinical pharmacists in daily audits, under the direction of an antimicrobial stewardship program, of antibiotic treatment durations for the common inpatient disease states of community-acquired pneumonia (CAP) and urinary tract infection (UTI).

PATIENTS AND METHODS

This was a retrospective single-center cohort study that evaluated the difference in the duration of antibiotic therapy for CAP or non-catheter-associated UTI of hospitalized patients who received a daily audit by clinical pharmacists compared with patients who did not receive a daily audit. Retrospective chart review included randomly selected hospitalized patients diagnosed with CAP or UTI during preaudit and postaudit periods.

RESULTS

The preaudit group had 64 patients; and the postaudit group, 51 patients. The therapy duration was 7 days in the preaudit group and 6 days in the postaudit group (=.55). Fluoroquinolone use was reduced in the postaudit group and was significantly less than in the preaudit group (24 [37.5%] vs 7 [13.7%]; =.007).

CONCLUSION

The daily audits of clinical pharmacists may be an effective method to reduce the duration of antibiotic therapy and are effective in the reduction of fluoroquinolone use. Additional studies must be done to further investigate the effects of clinical pharmacist antimicrobial stewardship efforts.

摘要

目的

评估临床药师在抗菌药物管理计划指导下,对社区获得性肺炎(CAP)和尿路感染(UTI)这两种常见住院疾病状态的抗生素治疗疗程进行日常审核的效果。

患者与方法

这是一项回顾性单中心队列研究,评估接受临床药师日常审核的住院患者与未接受日常审核的患者在CAP或非导管相关性UTI抗生素治疗疗程上的差异。回顾性病历审查包括在审核前和审核后期间随机选择的诊断为CAP或UTI的住院患者。

结果

审核前组有64例患者;审核后组有51例患者。审核前组的治疗疗程为7天,审核后组为6天(=0.55)。审核后组氟喹诺酮类药物的使用减少,且显著低于审核前组(24例[37.5%]对7例[13.7%];=0.007)。

结论

临床药师的日常审核可能是缩短抗生素治疗疗程的有效方法,并且在减少氟喹诺酮类药物使用方面有效。必须开展更多研究以进一步调查临床药师抗菌药物管理工作的效果。

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