Soontaros Suluck, Leelakanok Nattawut, Mepradis Yuttaphum, Auamnoy Titinun
Department of Pharmacy, Chonburi Hospital, Chonburi 20000, Thailand.
Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand.
Transl Clin Pharmacol. 2022 Dec;30(4):187-200. doi: 10.12793/tcp.2022.30.e18. Epub 2022 Dec 12.
The treatment of carbapenem-resistant (CRE) is diverse in each region due to the difference in local resistant patterns of CRE. We aimed to explore how physicians in Thailand decide on selection options for treating CRE infections. In this study, 25 physicians who were not infectious disease (ID) specialists participated in this semi-structured in-depth interview. We found that they, in general, did not provide empiric antibiotics for the treatment of CRE. However, some patients, e.g., those with prior carbapenems exposure may have brought CRE to physicians' attention. ID specialists played critical roles in both empiric and specific CRE treatment. There were multiple scenarios when CRE management deviated from recommendations, especially when physicians perceived that the evidence that supported the recommendations was weak. Several supportive factors, challenges, and improvements were also suggested. In conclusion, ID specialists, adequate information, and consistent implementation of infectious control policy are crucial to the treatment and prevention of CRE infection.
由于碳青霉烯类耐药肠杆菌科细菌（CRE）的局部耐药模式存在差异，每个地区对CRE的治疗方法各不相同。我们旨在探讨泰国的医生如何决定治疗CRE感染的选择方案。在这项研究中，25名非传染病（ID）专科医生参与了这次半结构化深入访谈。我们发现，他们一般不会提供经验性抗生素来治疗CRE。然而，一些患者，例如那些之前接触过碳青霉烯类药物的患者，可能会引起医生对CRE的关注。ID专科医生在经验性和特异性CRE治疗中都发挥着关键作用。在多种情况下，CRE的管理偏离了建议，尤其是当医生认为支持这些建议的证据不足时。还提出了几个支持因素、挑战和改进措施。总之，ID专科医生、充分的信息以及传染病控制政策的持续实施对于CRE感染的治疗和预防至关重要。
