抗生素敏感性测试结果的选择性报告：对一项助推策略的回顾性评估，该策略旨在改善住院成人产AmpC感染的抗生素处方情况
Selective reporting of antibiotic susceptibility testing results: a retrospective evaluation of a nudging strategy to improve antibiotic prescribing for ampC-producing infections in hospitalized adults.
作者信息
Lim Andy, McSweeney Terrence, Thwe Phyu M, Chang Mei H, Bao Hongkai, Lee Philip, Cowman Kelsie, Nori Priya, Guo Yi
机构信息
Montefiore Medical Center Department of Pharmacy, Albert Einstein College of Medicine, 111 E 210th Street, The Bronx, NY 10467, USA.
Department of Pharmacy, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA.
出版信息
Ther Adv Infect Dis. 2025 Jun 20;12:20499361251338017. doi: 10.1177/20499361251338017. eCollection 2025 Jan-Dec.
BACKGROUND
Moderate-risk ampC beta-lactamase-producing (HECK-Yes organisms) render many beta-lactams ineffective.
OBJECTIVE
This study evaluates selective reporting (SR) of antimicrobial susceptibility testing (AST) results to improve antibiotic prescribing for these infections.
DESIGN
A retrospective quasi-experimental study evaluating patients before and after the implementation of SR.
METHODS
SR of AST results for HECK-Yes organisms was implemented at a 1500-bed medical center. A retrospective study compared antibiotic prescribing before and after implementation in patients with positive blood or respiratory cultures.
RESULTS
Fifty patients were included in both pre- and post-implementation groups with similar baseline characteristics. Post-implementation, appropriate antibiotics within 24 h of AST report increased by 24% (62% pre vs 86% post, = 0.01). A total of 30-day mortality, clinical success, and microbiological failure rates were similar between groups.
CONCLUSION
SR improved appropriate antibiotic prescribing for moderate-risk ampC-producing (e.g., HECK-Yes) infections.
背景
产AmpCβ-内酰胺酶的中度风险菌（HECK-Yes菌）可使许多β-内酰胺类药物失效。
目的
本研究评估抗菌药物敏感性试验（AST）结果的选择性报告（SR），以改善针对这些感染的抗生素处方。
设计
一项回顾性准实验研究，评估实施SR前后的患者情况。
方法
在一家拥有1500张床位的医疗中心实施针对HECK-Yes菌的AST结果的SR。一项回顾性研究比较了血培养或呼吸道培养呈阳性的患者在实施前后的抗生素处方情况。
结果
实施前后两组各纳入50例患者，基线特征相似。实施后，AST报告后24小时内使用恰当抗生素的比例提高了24%（实施前为62%，实施后为86%，P = 0.01）。两组间的30天死亡率、临床成功率和微生物学失败率相似。
结论
SR改善了针对产中度风险AmpC菌（如HECK-Yes菌）感染的恰当抗生素处方。
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