研究文章雷竞技app下载苹果版

社区获得性肺炎的经验性抗生素处方和与广谱抗生素使用相关的患者特征

摘要

目的:评估入院后24小时内社区获得性肺炎(CAP)的经验管理对澳大利亚治疗指南(ATG)的依从性，并调查轻至中重度肺炎患者使用广谱抗生素的相关特征。方法:对在普通医疗部门12个月期间接受CAP的患者进行回顾性横断面研究。CAP定义为急性发作的呼吸道症状，并伴有新的胸部x线浸润，治疗小组诊断为CAP。肺炎严重程度通过CORB评分评估。从病历中收集相关资料。结果:共鉴定CAP患者395例，纳入285例。平均年龄66±16岁;男性53%，12%来自家庭护理。轻度CAP组167例(59%)，中度CAP组75例(26%)，重度CAP组43例(15%)。93%的患者接受了典型和非典型病原体的抗生素覆盖，尽管轻度至中度组中有35%的患者接受了肠外大环内酯。62%接受头孢曲松; 92 (55%), 53 (71%) and 33 (77%) with mild, moderate and severe CAP, respectively. Compliance with ATG was seen in 16%, 27% and 72% cases of mild, moderate and severe CAP, with an overall compliance of 26%. Advanced age and dependent in personal activities of daily living (PADL) had a significant univariate association with ceftriaxone prescription. However, in the multivariate analysis, only advanced age was found to have a significant association. The length of stay was similar between those who received ceftriaxone (4.3 ± 2.4 days) and benzylpenicillin (4.1 ± 2.0 days) Conclusion: Adherence to the ATG guideline is poor, especially in the mild to moderately severe disease. Older patients are more likely to receive ceftriaxone. Studies are required to identify the barriers to adherence to CAP guidelines and factors that influence the prescription of broad spectrum antibiotics.

Mahesan Anpalahan*， Mirza Baig, Evan Newnham, Roza Nastovska, Jessica Manzoni, Daniel Clayton-Chubb

阅读全文下载全文|访问全文