在转诊儿科重症监护病房中抗菌药物的使用情况及其质量。
Impact and quality of antimicrobial use in a referral pediatric intensive care unit.
机构信息
Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Department of Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Network Research on Epidemiology and Public Health, CIBERESP, Madrid, Spain.
Pharmacy Department, Sant Joan de Déu Hospital, Barcelona, Spain.
出版信息
Enferm Infecc Microbiol Clin (Engl Ed). 2022 Feb;40(2):78-81. doi: 10.1016/j.eimce.2021.05.013.
INTRODUCTION
We aimed to describe antimicrobial use (AU) and quality of prescriptions (QP) in a 28-bed medical-surgical PICU of a European referral children's hospital during 2019.
METHODS
AU data were expressed as days-of-therapy (DOT) over 100 days-present (DP) and as length-of-treatment (LOT). QP was based on monthly cross-sectional point-prevalence surveys. Length-of-stay (LOS), readmission rates (RR), and mortality rates (MR) were also collected.
RESULTS
PICU AU accounted for 13.5% of the global hospital AU; the median PICU density of AU was 1.4 (IQR 1.3-1.5) times higher than that of the rest of the hospital areas. Antibacterials represented 88.5% of the overall AU, cefazolin and amoxicillin-clavulanate being the most used drugs. A high QP rate was observed (149/168 optimal, 88.9%), with room for improvement in prophylactic regimens and de-escalation of broad-spectrum regimens. LOT, LOS, RR, and MR remained stable.
CONCLUSIONS
PICU AU represented a major portion of the global hospital AU. Despite high QP rates, prophylactic and broad-spectrum antibiotic regimens were optimizable.
简介
我们旨在描述 2019 年期间，一家欧洲转诊儿童医院的 28 张病床的内科-外科 PICU 中的抗菌药物使用（AU）和处方质量（QP）。
方法
AU 数据表示为 100 天内的治疗日（DOT）与 100 天内的现患率（DP）之比，以及治疗持续时间（LOT）。QP 基于每月的横断面点患病率调查。还收集了住院时间（LOS）、再入院率（RR）和死亡率（MR）。
结果
PICU 的 AU 占医院总 AU 的 13.5%；PICU 的 AU 密度中位数比医院其他区域高 1.4（IQR 1.3-1.5）倍。抗菌药物占总 AU 的 88.5%，头孢唑林和阿莫西林-克拉维酸是最常用的药物。QP 率很高（168 个处方中有 149 个是最佳的，88.9%），预防方案和广谱方案的降级仍有改进的空间。LOT、LOS、RR 和 MR 保持稳定。
结论
PICU 的 AU 占医院总 AU 的很大一部分。尽管 QP 率较高，但预防性和广谱抗生素方案仍可优化。
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