未经评估:抗生素降级是限制耐药性传播和出现的抗菌药物管理计划的关键要素。进行这项研究以评估大肠杆菌或甲氧西林敏感金黄色葡萄球菌(MSSA)的阳性培养敏感性报告对抗生素治疗降阶梯的影响。
UNASSIGNED:这项前瞻性观察性研究是对256名感染患者进行的。样品主要是从感染部位的脓液中获得的,用于鉴定病原体和培养敏感性测试。数据是从病人的医疗档案中收集的,其中包括他们的人口统计数据,样品类型,作为基于培养的经验性或确定性治疗的致病微生物和抗菌治疗。数据采用SPSS进行分析。
未经证实:在256个分离的微生物中,138(53.9%)为MSSA,118为大肠杆菌(46.1%)。MSSA对头孢西丁100%敏感,苯唑西林,万古霉素,磷霉素,粘菌素和超过90%的利奈唑胺(95.3%),替加环素(93.1%),氯霉素(92.2%)和阿米卡星(90.2%)。大肠杆菌仅对磷霉素有100%的敏感性,对粘菌素有90%以上的敏感性(96.7%),多粘菌素B(95.1%)和替加环素(92.9%)。头孢哌酮+舒巴坦的高使用率(151),阿米卡星(149),头孢曲松(33),甲硝唑(30)和哌拉西林+他唑巴坦(22)见于经验性处方。在敏感性测试之后,大肠杆菌最常见的抗生素是美罗培南IV(34),阿米卡星(34),环丙沙星(29)和头孢哌酮+舒巴坦(25)。对于MSSA案例,利奈唑胺(48),克林霉素(30),头孢哌酮+舒巴坦IV(16)和阿米卡星(15)常用。总的来说,大肠杆菌的抗生素使用减少了23%,MSSA病例减少了43%.
UNASSIGNED:文化敏感性报告有助于抗菌治疗的降级,减少特别是广谱抗生素的处方。因此,建议根据当地抗菌药物敏感性模式制定当地医院指南,同时防止不必要地使用广谱抗生素进行经验性治疗.
UNASSIGNED: Antibiotic de-escalation is a key element of antimicrobial stewardship programs that restrict the spread and emergence of resistance. This study was performed to evaluate the impact of positive culture sensitivity
reports of E. coli or Methicillin sensitive Staphylococcus aureus (MSSA) on de-escalation of antibiotic therapy.
UNASSIGNED: This prospective observational study was performed on 256 infected patients. The samples were obtained principally from the pus of infected sites for the identification of pathogens and culture-sensitivity testing. The data were collected from patient medical files, which included their demographic data, sample type, causative microbe and antimicrobial treatment as empiric or definitive treatment based on cultures. Data were analyzed using SPSS.
UNASSIGNED: Of 256 isolated microbes, 138 (53.9%) were MSSA and 118 were E. coli (46.1%). MSSA showed 100% sensitivity to cefoxitin, oxacillin, vancomycin, fosfomycin, colistin and more than 90% to linezolid (95.3%), tigecycline (93.1%), chloramphenicol (92.2%) and amikacin (90.2%). E. coli showed 100% sensitivity to only fosfomycin and more than 90% to colistin (96.7%), polymyxin-B (95.1%) and tigecycline (92.9%). The high use of cefoperazone+sulbactam (151), amikacin (149), ceftriaxone (33), metronidazole (30) and piperacillin + tazobactam (22) was seen with empiric prescribing. Following susceptibility testing, the most common antibiotics prescribed for E. coli were meropenem IV (34), amikacin (34), ciprofloxacin (29) and cefoperazone+sulbactam (25). For MSSA cases, linezolid (48), clindamycin (30), cefoperazone+ sulbactam IV (16) and amikacin (15) was used commonly. Overall, there was 23% reduction in antibiotic use in
case of E. coli and 43% reduction in MSSA cases.
UNASSIGNED: Culture sensitivity
reports helped in the de-escalation of antimicrobial therapy, reducing the prescribing of especially broad-spectrum antibiotics. Consequently, it is recommended that local hospital guidelines be developed based on local antimicrobial susceptibility patterns while preventing the unnecessary use of broad-spectrum antibiotics for empiric treatment.