Khan Luqman, Naz Falak, Zeb Maria, Rehman Said U
Internal Medicine, Hayatabad Medical Complex, Peshawar, PAK.
Gynecology and Obstetrics, Lady Reading Hospital, Peshawar, PAK.
Cureus. 2024 Nov 13;16(11):e73623. doi: 10.7759/cureus.73623. eCollection 2024 Nov.
Background Antimicrobial resistance and incorrect use of antibiotics may worsen hospital-acquired pneumonia (HAP), which is a serious illness associated with healthcare and is related to higher rates of morbidity and death. Objective This study aimed to evaluate the effectiveness of antibiotic stewardship programs (ASPs) in optimizing the treatment of HAP, focusing on improving patient outcomes and reducing resistance. Methodology A prospective cohort study was conducted from August 2022 to July 2023. Data were gathered on the demographics, comorbidities, antibiotic treatment plans, and clinical outcomes of adult patients with HAP diagnoses. The efficacy of ASPs was evaluated by statistical studies, which included logistic regression. Results A total of 428 participants were assessed, with notable differences between the no stewardship group (n = 220, 51.40%) and the stewardship group (n = 208, 48.60%). The stewardship group demonstrated a higher treatment success rate (n = 182, 87.5%) compared to the no stewardship group (n = 126, 57.3%). The 30-day readmission rate was lower in the stewardship group (n = 32, 15.4%) versus the no stewardship group (n = 58, 26.4%), and adverse drug reactions were reduced in the stewardship group (n = 15, 7.2%) compared to the no stewardship group (n = 45, 20.5%). In-hospital mortality was significantly lower in the stewardship group (n = 16, 7.7%) than in the no stewardship group (n = 40, 18.2%). Conclusion The results show that ASP implementation greatly improves clinical outcomes for HAP patients, highlighting the need for ongoing funding in ASPs to address antibiotic resistance.
抗菌药物耐药性以及抗生素的不当使用可能会使医院获得性肺炎（HAP）恶化，HAP是一种与医疗保健相关的严重疾病，与较高的发病率和死亡率相关。目的：本研究旨在评估抗生素管理计划（ASP）在优化HAP治疗方面的有效性，重点是改善患者预后并降低耐药性。方法：于2022年8月至2023年7月进行了一项前瞻性队列研究。收集了成年HAP诊断患者的人口统计学、合并症、抗生素治疗方案和临床结局数据。通过包括逻辑回归在内的统计研究评估了ASP的疗效。结果：共评估了428名参与者，无管理组（n = 220，51.40%）和管理组（n = 208，48.60%）之间存在显著差异。与无管理组（n = 126，57.3%）相比，管理组的治疗成功率更高（n = 182，87.5%）。管理组的30天再入院率（n = 32，15.4%）低于无管理组（n = 58，26.4%），与无管理组（n = 45，20.5%）相比，管理组的药物不良反应有所减少（n = 15，7.2%）。管理组的院内死亡率（n = 16，7.7%）显著低于无管理组（n = 40，18.2%）。结论：结果表明，实施ASP可显著改善HAP患者的临床结局，突出了持续为ASP提供资金以应对抗生素耐药性的必要性。
