Aghaie Jaleh, Lisby Marianne, Jessen Marie Kristine
Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark.
Department of Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
Clin Exp Emerg Med. 2025 Mar;12(1):66-75. doi: 10.15441/ceem.24.219. Epub 2024 May 23.
Fluids administered as drug diluents with intravenous (IV) medicine constitute a substantial fraction of fluids in inpatients. Whether physicians are aware of fluid volumes administered with IV antibiotics for patients with suspected infections is unclear. Moreover, whether this leads to adjustments in 24-hour fluid administration/antibiotics is unknown.
This cross-sectional interview-based study was conducted in three emergency departments. Physicians were interviewed after prescribing around-the-clock IV antibiotics for ≥24 hours to patients with suspected infection. A structured interview guide assessed the physicians' awareness, considerations, and practices when prescribing IV antibiotics. The 24-hour antibiotic fluid volume was calculated.
We interviewed 100 physicians. The 24-hour fluid volume administered with IV antibiotics was 400 mL (interquartile range, 300-400 mL). Overall, 53 physicians (53%) were unaware of the fluid volume administered with IV antibiotics. Moreover, 76 (76%) did not account for the antibiotic fluid volume in the 24-hour fluid administration, and 96 (96%) indicated that they would not adjust prescribed fluids after receiving information about 24-hour antibiotic fluid volume administered for their patient. No comorbidities associated with fluid intolerance were the primary reason for not adjusting prescribed fluids/ antibiotics. Approximately 79 (79%) opted for visibility of fluid volumes administered with IV antibiotics in the medical record.
The majority of physicians were unaware of fluid volumes administered as a drug diluent with IV antibiotics. The majority chose not to make post-prescribing adjustments to their planned fluid administration; they regarded their patient as fluid tolerant. The physicians opted for visibility of fluid volumes administered as diluents during the prescribing process.
作为静脉注射药物稀释剂使用的液体在住院患者所使用的液体中占很大比例。尚不清楚医生是否知晓给疑似感染患者静脉注射抗生素时所使用的液体量。此外，这是否会导致24小时液体输注量/抗生素使用量的调整尚不清楚。
这项基于访谈的横断面研究在三个急诊科进行。在为疑似感染患者开具持续静脉注射抗生素≥24小时后，对医生进行访谈。一份结构化访谈指南评估了医生在开具静脉注射抗生素时的知晓情况、考虑因素和做法。计算24小时抗生素液体量。
我们访谈了100名医生。静脉注射抗生素时24小时的液体量为400毫升（四分位间距，300 - 400毫升）。总体而言，53名医生（53%）不知道静脉注射抗生素时的液体量。此外，76名（76%）医生在24小时液体输注中未考虑抗生素液体量，96名（96%）医生表示在收到关于其患者24小时抗生素液体量的信息后不会调整所开具的液体量。没有与液体不耐受相关的合并症是不调整所开具的液体量/抗生素的主要原因。大约79名（79%）医生选择在病历中显示静脉注射抗生素时的液体量。
大多数医生不知道作为静脉注射抗生素稀释剂使用的液体量。大多数医生选择在开具处方后不对计划的液体输注进行调整；他们认为自己的患者能够耐受液体。医生们选择在开具处方过程中显示作为稀释剂使用的液体量。
