Biniek Joachim Peter, Schwab Frank, Graf Karolin, Vonberg Ralf-Peter
Department of Hospital Hygiene, Paracelsus-Hospital am Silbersee, 30851 Langenhagen, Germany.
Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, 12203 Berlin, Germany.
Antibiotics (Basel). 2024 Jul 10;13(7):635. doi: 10.3390/antibiotics13070635.
This retrospective study aimed to assess and compare guideline adherence and treatment costs in the management of urinary tract infections (UTIs) and bloodstream infections (BSIs) in German tertiary hospitals from January 2019 to December 2020. The study analyzed 586 patient records, with 65% diagnosed with UTIs and 35% with BSIs. Antibiotic treatment was given to 98% of patients, but only 65% received microbiological diagnostics. Bacterial growth was observed in 86% of patients with cultures taken, with being the leading pathogen. The treatment was intravenous in 63% of cases, with Ceftriaxone as the leading antibiotic agent. The guideline adherence was found to be low, at 33%. Multivariable logistic regression analysis revealed that patients with urogenital risk factors (OR = 1.589; < 0.001) and increasing age (OR = 1.01; = 0.007) were significantly more likely to receive guideline-concordant treatment for UTIs and BSIs. Additionally, complicating factors such as diabetes and renal dysfunction were associated with higher adherence rates, underscoring the importance of targeted antibiotic stewardship interventions.
这项回顾性研究旨在评估和比较2019年1月至2020年12月德国三级医院在治疗尿路感染（UTIs）和血流感染（BSIs）方面的指南遵循情况及治疗成本。该研究分析了586份患者记录，其中65%被诊断为UTIs，35%被诊断为BSIs。98%的患者接受了抗生素治疗，但只有65%的患者接受了微生物诊断。在进行培养的患者中，86%观察到细菌生长，[具体细菌名称未给出]是主要病原体。63%的病例采用静脉治疗，头孢曲松是主要的抗生素药物。发现指南遵循率较低，为33%。多变量逻辑回归分析显示，有泌尿生殖系统风险因素的患者（OR = 1.589；P < 0.001）以及年龄增长（OR = 1.01；P = 0.007）更有可能接受针对UTIs和BSIs的指南一致性治疗。此外，糖尿病和肾功能不全等复杂因素与更高的遵循率相关，这突出了针对性抗生素管理干预措施的重要性。
