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尼日利亚一家三级医院抗菌药物处方和使用的现患率调查:抗菌药物管理计划的切入点。

Point Prevalence Survey of Antimicrobial Prescription and Consumption in a Nigerian Tertiary Hospital: A Gateway to the Antimicrobial Stewardship Program.

机构信息

Department of Medical Microbiology, University of Nigeria Teaching Hospital Ituku- Ozalla, Enugu State, Nigeria.

Department of Medical Microbiology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu State, Nigeria.

出版信息

Niger J Clin Pract. 2024 Jun 1;27(6):702-707. doi: 10.4103/njcp.njcp_449_23. Epub 2024 Jun 29.

Abstract

BACKGROUND

Antimicrobial stewardship is an important action plan for curbing the rising trend of antimicrobial resistance (AMR). Surveillance of antimicrobial use and consumption is needed as baseline data and for monitoring the impact of antimicrobial stewardship interventions. The survey was done to understand the burden of AMR, in view of establishing an antimicrobial stewardship program in our hospital.

METHODS

A point prevalence survey (PPS) of antimicrobial use and consumption was conducted on all inpatients admitted before 8.00 am on the days of the survey using a standardized questionnaire. The collected data were entered online into the Global PPS web-based application (www.global-pps.com), for analysis.

RESULT

Of the 178 patients admitted during the survey period, 50.6% were on one or more antimicrobial agents. All the patients in adult intensive care units were on antibiotics (100%), followed by neonatal intensive care units (83.3%), with the least being adult medical wards (39.4%). Beta-lactam antibiotics were the most frequently prescribed antimicrobial for various infections, especially skin and soft tissue infections, 41.3%, which were the most common diagnoses treated with antibiotics. The infection was mostly community-acquired (81.6%), of which 94.9% were treated empirically. There was no written guideline in existence.

CONCLUSION

The present study revealed a poor prescribing habit because of a high rate of empirical treatment. The need for antimicrobial stewardship cannot be overemphasized as it will help streamline and improve the prescribing pattern.

摘要

背景

抗菌药物管理是遏制抗菌药物耐药性(AMR)上升趋势的重要行动计划。需要监测抗菌药物的使用和消耗,作为基准数据,并监测抗菌药物管理干预措施的影响。这项调查是为了了解 AMR 的负担,以便在我们的医院建立抗菌药物管理计划。

方法

使用标准化问卷,对调查当天上午 8 点前入院的所有住院患者进行抗菌药物使用和消耗的时点患病率调查(PPS)。收集的数据在线输入到全球 PPS 网络应用程序(www.global-pps.com)进行分析。

结果

在调查期间,178 名入院患者中,有 50.6%的患者使用了一种或多种抗菌药物。所有成人重症监护病房的患者都使用了抗生素(100%),其次是新生儿重症监护病房(83.3%),而成人内科病房使用的抗生素最少(39.4%)。β-内酰胺类抗生素是治疗各种感染最常开的抗菌药物,尤其是皮肤和软组织感染,占 41.3%,这是抗生素治疗最常见的诊断。感染大多为社区获得性(81.6%),其中 94.9%的患者接受了经验性治疗。目前还没有书面的指南。

结论

本研究显示,由于经验性治疗率较高,处方习惯较差。抗菌药物管理的必要性怎么强调都不为过,因为它将有助于简化和改善处方模式。

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