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重症监护病房医生和临床药师在重症监护环境中全身用抗真菌药物处方知识与实践的评估:一项横断面研究。

Evaluation of Systemic Antifungal Prescribing Knowledge and Practice in the Critical Care Setting among ICU Physicians and Clinical Pharmacists: A Cross-Sectional Study.

作者信息

Ibrahim Sahar Mohamed, Adlan Nosiyba, Alomair Sufyan Mohammed, Butaiban Ibrahim, Alsalman Ahmed, Bawazeer Abdulmajeed, Alqahtani Monahi, Mohamed Dalia, Emeka Promise Madu

机构信息

Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsaa 31982, Saudi Arabia.

Department of Pharmacy, Almoosa Specialist Hospital, Al-Ahsaa 31982, Saudi Arabia.

出版信息

Antibiotics (Basel). 2023 Jan 23;12(2):238. doi: 10.3390/antibiotics12020238.

Abstract

Management of invasive fungal infections (IFI) and subsequent treatment choices remain challenging for physicians in the ICU. Documented evidence shows increased practice of the inappropriate use of antifungal agents in the ICU. Continuous education of healthcare providers (HCPs) represents the cornerstone requirement for starting an antifungal stewardship program (AFS). This study aimed at evaluating knowledge gaps in systemic antifungal prescribing among physicians and clinical pharmacists in a critical care setting. A cross-sectional, multi-center, survey-based study was conducted in five tertiary hospitals located in Al-Ahsaa, Saudi Arabia between January and May 2021. A self-administered questionnaire was distributed among the targeted clinicians. A total of 63 clinicians were involved (65.5% ICU physicians and 34.5% clinical pharmacists). It was noted that a minority of the participating HCPs (3.2%) had overall good knowledge about antifungal prescribing, but the majority had either moderate (46%) or poor (50.8%) knowledge. The difference in overall knowledge scores between the ICU physicians and the clinical pharmacists ( = 0.925) was not significant. However, pharmacists showed better scores for the pharmacokinetics of antifungal therapy ( = 0.05). This study has revealed a significant gap in the knowledge and practice of clinicians as regards prescribing antifungal therapy in our area. Although the results cannot be generalized, the outcome of this study has exposed the need for a tailored training program essential for carrying out an AFS program.

摘要

对于重症监护病房(ICU)的医生而言,侵袭性真菌感染(IFI)的管理及后续治疗选择仍然具有挑战性。有记录的证据表明,ICU中抗真菌药物使用不当的情况日益增多。持续对医疗服务提供者(HCPs)进行教育是启动抗真菌管理计划(AFS)的基本要求。本研究旨在评估重症监护环境下医生和临床药师在全身抗真菌处方方面的知识差距。2021年1月至5月期间,在沙特阿拉伯艾哈萨的五家三级医院开展了一项基于调查的横断面多中心研究。向目标临床医生发放了一份自填式问卷。共有63名临床医生参与(65.5%为ICU医生,34.5%为临床药师)。值得注意的是,少数参与的HCPs(3.2%)对抗真菌处方总体了解良好,但大多数人的知识水平为中等(46%)或较差(50.8%)。ICU医生和临床药师在总体知识得分上的差异(=0.925)不显著。然而,药师在抗真菌治疗的药代动力学方面得分更高(=0.05)。本研究揭示了我们地区临床医生在抗真菌治疗处方的知识和实践方面存在显著差距。尽管结果不能一概而论,但本研究的结果表明需要开展一项针对AFS计划的定制培训项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5819/9952359/853c4ebdb926/antibiotics-12-00238-g001.jpg

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