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儿科社区获得性肺炎抗生素管理:一项干预前后研究。

Pediatric Antibiotic Stewardship for Community-Acquired Pneumonia: A Pre-Post Intervention Study.

机构信息

Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Clin Pediatr (Phila). 2022 Nov;61(11):795-801. doi: 10.1177/00099228221102827. Epub 2022 Jun 8.

Abstract

We aimed to investigate the effectiveness of an antibiotic stewardship program (ASP) on antibiotic prescription in children with community-acquired pneumonia (CAP). Antibiotic purchasing data were collected for children aged 3 months to 18 years diagnosed with CAP from November 2016 to April 2017 (pre-intervention period) and from November 2017 to April 2018 (post-intervention period). The intervention was a 1-day seminar for primary care pediatricians on the diagnosis and treatment of CAP in children according to national guidelines. There was a substantial decrease in the use of azithromycin after the intervention. In younger children, there was a 42% decrease, alongside an increased use of amoxicillin ( < .001). In older children, there was a smaller, non-statistically significant decrease in the use of azithromycin ( = .45). Our data demonstrate that the implementation of an ASP was associated with a reduction in the use of broad-spectrum antibiotics and macrolides and increased guideline adherence for the safe treatment of CAP.

摘要

我们旨在研究抗生素管理计划(ASP)对儿童社区获得性肺炎(CAP)抗生素处方的有效性。从 2016 年 11 月至 2017 年 4 月(干预前)和 2017 年 11 月至 2018 年 4 月(干预后),我们收集了 3 个月至 18 岁儿童的抗生素购买数据,这些儿童被诊断为 CAP。干预措施是针对初级保健儿科医生的为期一天的研讨会,根据国家指南介绍儿童 CAP 的诊断和治疗。干预后,阿奇霉素的使用量大幅减少。在年龄较小的儿童中,阿奇霉素的使用量减少了 42%,同时阿莫西林的使用量增加(<.001)。在年龄较大的儿童中,阿奇霉素的使用量减少幅度较小,无统计学意义(=.45)。我们的数据表明,ASP 的实施与减少广谱抗生素和大环内酯类药物的使用以及增加安全治疗 CAP 的指南依从性有关。

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