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评估阿莫西林在社区获得性肺炎患者中的应用,这些患者的意识障碍、尿素、呼吸频率、血压评分低且年龄≥65岁(CURB-65评分):一项回顾性研究。

Evaluating the Use of Amoxicillin in Community-Acquired Pneumonia Patients With Low Confusion, Urea, Respiratory Rate, Blood Pressure, and Age ≥65 Years (CURB-65) Scores: A Retrospective Study.

作者信息

Anand Trimanjot Singh, Chua Wilsonne Andrew Kyle T, Jung Soo Hyun, Cristea-Nicoara Daniela

机构信息

Internal Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR.

Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR.

出版信息

Cureus. 2025 Jun 21;17(6):e86477. doi: 10.7759/cureus.86477. eCollection 2025 Jun.

Abstract

Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality worldwide, necessitating precise antibiotic strategies guided by severity assessment tools such as the confusion, urea, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score. This retrospective study evaluated initial antibiotic choices for patients with low CURB-65 scores (0 and 1) at Glenfield Hospital, University Hospitals of Leicester NHS Trust, focusing on the role of amoxicillin in early-stage pneumonia management. Data from 400 patients across various hospital settings in 2023 were analyzed. Co-amoxiclav was the most prescribed antibiotic, used in 226 cases (62.78%), while amoxicillin was prescribed in 46 cases (12.78%). Despite the small sample size and lack of comorbidity adjustment, the study found a high discharge rate (40 patients, or 86.95%) and low readmission rate (four patients, or 8.70%) for patients initially treated with amoxicillin, supporting its potential as a first-line therapy for low-risk CAP. However, broader studies with more comprehensive data are needed to confirm these findings and refine clinical guidelines, including biomarker integration for more precise prescribing.

摘要

社区获得性肺炎(CAP)仍是全球发病和死亡的重要原因,因此需要借助诸如意识模糊、尿素、呼吸频率、血压及年龄≥65岁(CURB-65)评分等严重程度评估工具来制定精确的抗生素治疗策略。这项回顾性研究评估了莱斯特大学医院国民保健服务信托基金旗下格伦菲尔德医院CURB-65评分较低(0分和1分)的患者的初始抗生素选择,重点关注阿莫西林在早期肺炎治疗中的作用。分析了2023年来自不同医院环境的400例患者的数据。复方阿莫西林是最常开具的抗生素,226例(62.78%)使用了该药物,而阿莫西林开具了46例(12.78%)。尽管样本量小且未对合并症进行调整,但该研究发现,最初接受阿莫西林治疗的患者出院率较高(40例,占86.95%),再入院率较低(4例,占8.70%),这支持了阿莫西林作为低风险CAP一线治疗药物的潜力。然而,需要开展更广泛的研究并获取更全面的数据来证实这些发现并完善临床指南,包括整合生物标志物以实现更精准的处方。

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