Barriers to an early switch from Intravenous to oral antibiotic therapy in hospitalised patients with CAP
Barriers to an early switch from Intravenous to oral antibiotic therapy in hospitalised patients with CAP
复制标题
DOI：
10.1183/09031936.00029412
复制
发表时间：
2013-01-01
影响因子：
24.3
通讯作者：
Oosterheert, Jan Jelrik
中科院分区：
文献类型：
--
作者：
Engel, Madelon F.;Postma, Douwe F.;Oosterheert, Jan Jelrik
在临床稳定的社区获得性肺炎(CAP)住院患者中，医生是否采用早期转换策略(从静脉注射到口服抗生素)？如果不是，为什么不呢？在一项多中心前瞻性队列研究中，成年患者接受了静脉注射。包括CAP治疗。在抗生素治疗的第三天，评估临床稳定性，并询问治疗住院医生他们的转换策略。此外，还采访了治疗医生，以评估他们对指南建议的了解和遵守。162名患者中的149名(92%)和107名医生中的97名(91%)接受了采访。在治疗的第三天，149名患者中有68名(46%)有可能改用口服抗生素，但68名患者中有27名(40%)没有改用口服抗生素。推迟转换的患者因素是高抑制-65(新发病混乱，尿素和gt；7mmol.L-1，呼吸频率=30次呼吸.min(-1)，血压
Do physicians apply an early-switch strategy (from intravenous to oral antibiotics) in clinically stable patients hospitalised with community-acquired pneumonia (CAP)? If not, why not?In a multicentre prospective cohort study, adult patients admitted for i.v. CAP treatment were included. On day 3 of antibiotic treatment, clinical stability was assessed and treating resident physicians were interviewed on their switch strategies. Additionally, treating physicians were interviewed to evaluate their knowledge of and adherence to guideline advice.149 (92%) out of 162 patients were included and 97 (91%) out of 107 physicians were interviewed. A switch to oral antibiotics was possible in 68 (46%) out of 149 patients on day 3 of treatment but not performed in 27 (40%) out of 68. Patient factors delaying the switch were high CURB-65 (confusion of new onset, urea >7 mmol.L-1, respiratory rate of >= 30 breaths.min(-1), blood pressure