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评估沙特阿拉伯门诊胃肠外抗菌治疗(OPAT)项目的有效性:一项回顾性研究。

Evaluate the Effectiveness of Outpatient Parenteral Antimicrobial Therapy (OPAT) Program in Saudi Arabia: A Retrospective Study.

作者信息

Al Shareef Haneen J, Al Harbi Adnan, Alatawi Yasser, Aljabri Ahmed, Al-Ghanmi Mohammed A, Alzahrani Mohammed S, Algarni Majed Ahmed, Khobrani Attiah, Haseeb Abdul, AlSenani Faisal, Elrggal Mahmoud E

机构信息

Clinical Pharmacy, King Abdullah Medical City, Makkah 21955, Saudi Arabia.

College of Pharmacy, Umm Al Qura University, Makkah 21955, Saudi Arabia.

出版信息

Antibiotics (Basel). 2022 Mar 24;11(4):441. doi: 10.3390/antibiotics11040441.

Abstract

(1) Background: Outpatient parenteral antibiotic therapy (OPAT) is a well-established and cost-effective measure that improves the efficient use of healthcare resources and increases bed availability. Only limited published data is available to illustrate OPAT implementation and outcomes in Saudi Arabia. The main objective of this study was to evaluate the effectiveness of OPAT in a tertiary center in Saudi Arabia. (2) Methods: In this retrospective study, clinical charts of enrolled patients were reviewed in a tertiary care center from the initial month of November 2017 to March 2020. All admitted patients with a central line and who enrolled in the OPAT of the hospital during this study period were included. The primary outcome was the 30-days readmission rate of OPAT patients. Secondary outcomes were factors associated with OPAT failure. Descriptive analysis of the data was used to express the results. (3) Results: We enrolled 90 patients; 54 (60%) were male; the mean age was 55.16 (±17.7) years old. The mean duration of the antimicrobial treatment was 21.9 (+24.6) days. All patients completed the intended course of therapy. Ertapenem was the most frequently used antimicrobial (43%), followed by vancomycin (11.2%). Urinary tract infections (UTIs) are some of the most common bacterial infections in 25 patients (26.9%), followed by osteomyelitis in 16 patients (17.2%). Extended-spectrum beta-lactamase was the highest common isolated microorganism (44.9%), followed by methicillin-resistant Staphylococcus aureus MRSA (16.9%). The readmission to the hospital during therapy was required for 12 patients (13.3%). Shifting from hospital care to OPAT care resulted in cost savings of 18 million SAR in the overall assessment period and avoided a total of 1984 patient days of hospitalization. (4) Conclusion: The findings have shown that OPAT therapy was effective with minimum hospital readmissions and therapy complications. OPAT programs can reduce healthcare costs and should be integrated into practice.

摘要

(1) 背景:门诊胃肠外抗生素治疗(OPAT)是一项成熟且具成本效益的措施,可提高医疗资源的利用效率并增加床位供应。沙特阿拉伯仅有有限的已发表数据用于说明OPAT的实施情况和结果。本研究的主要目的是评估沙特阿拉伯一家三级医疗中心OPAT的有效性。(2) 方法:在这项回顾性研究中,对一家三级医疗中心2017年11月首个月份至2020年3月期间登记患者的临床病历进行了审查。纳入了在此研究期间所有入院且置入中心静脉导管并参与医院OPAT的患者。主要结局是OPAT患者的30天再入院率。次要结局是与OPAT失败相关的因素。使用数据的描述性分析来呈现结果。(3) 结果:我们纳入了90名患者;54名(60%)为男性;平均年龄为55.16(±17.7)岁。抗菌治疗的平均时长为21.9(+24.6)天。所有患者均完成了预定疗程。厄他培南是最常用的抗菌药物(43%),其次是万古霉素(11.2%)。尿路感染(UTIs)是25名患者(26.9%)中一些最常见的细菌感染,其次是16名患者(17.2%)的骨髓炎。超广谱β-内酰胺酶是最常见的分离微生物(44.9%),其次是耐甲氧西林金黄色葡萄球菌(MRSA,16.9%)。12名患者(13.3%)在治疗期间需要再次入院。在整个评估期内,从住院治疗转为OPAT治疗节省了1800万沙特里亚尔的成本,并避免了总共1984个患者住院日。(4) 结论:研究结果表明,OPAT治疗有效,医院再入院率和治疗并发症最少。OPAT项目可降低医疗成本,应纳入实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb0c/9026843/23d67cae414c/antibiotics-11-00441-g001.jpg

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