Masetla Mankoana A, Ntuli Pinky N, Abraham Veena, Godman Brian, Witika Bwalya A, Mudenda Steward, Skosana Phumzile P
Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa.
Department of Pharmacy, Dr. George Mukhari Academic Hospital, Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa.
Antibiotics (Basel). 2023 Jul 1;12(7):1142. doi: 10.3390/antibiotics12071142.
Bone and joint infections are associated with prolonged hospitalizations, high morbidity and complexity of care. They are difficult to treat, and successful therapy requires organism-specific antimicrobial therapy at high doses for a prolonged duration as recommended in standard treatment guidelines (STGs). Adherence to the treatment plan is equally important, which is enhanced with knowledge of the condition as well as appropriate antibiotics. Consequently, the aim of this study was to provide antimicrobial stewardship (AMS) services to outpatients with chronic bone and joint infections presenting to the orthopaedic clinic at a public South African tertiary hospital. A total of 44 patients participated in this study. Chronic osteomyelitis was diagnosed in 39 (89%) patients and septic arthritis in 5 (11%). The majority (43%) of infections were caused by followed by (14%). Seventy-one antibiotics were prescribed at baseline with rifampicin prescribed the most (39%), followed by ciprofloxacin (23%). The majority (96%) of the antibiotics were not prescribed according to the South African STG; however, interventions were only needed in 31% of prescribed antibiotics (n = 71) since the STG only recommends empiric therapy directed against . Seventy-seven percent of the patients obtained a high self-reported adherence score at baseline. Consequently, there is a need to improve AMS in bone and joint infections to improve future care.
骨与关节感染与住院时间延长、高发病率及护理复杂性相关。它们难以治疗，成功的治疗需要按照标准治疗指南（STGs）的建议，长时间使用高剂量的针对病原体的抗菌治疗。坚持治疗计划同样重要，了解病情以及使用合适的抗生素可增强治疗效果。因此，本研究的目的是为到南非一家公立三级医院骨科门诊就诊的慢性骨与关节感染门诊患者提供抗菌药物管理（AMS）服务。共有44名患者参与了本研究。39名（89%）患者被诊断为慢性骨髓炎，5名（11%）患者被诊断为化脓性关节炎。大多数感染（43%）由……引起，其次是……（14%）。基线时共开具了71种抗生素，其中利福平开具最多（39%），其次是环丙沙星（23%）。大多数（96%）抗生素的开具不符合南非STG；然而，由于STG仅推荐针对……的经验性治疗，因此仅31%（n = 71）的已开具抗生素需要进行干预。77%的患者在基线时自我报告的依从性得分较高。因此，有必要改善骨与关节感染的抗菌药物管理以改善未来的护理。
