Antibiotic use in Ontario facilities that provide chronic care
Antibiotic use in Ontario facilities that provide chronic care
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DOI：
10.1046/j.1525-1497.2001.016006376.x
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发表时间：
2001-06-01
影响因子：
5.7
通讯作者：
McGeer, A
中科院分区：
文献类型：
--
作者：
Loeb, M;Simor, AE;McGeer, A
目的：确定在提供慢性病护理的机构中抗生素使用的发生率和变异性，并确定当在这些机构中开抗生素处方时，符合感染临床标准的频率。设计：一项前瞻性、1个月、观察性队列研究。设置：安大略西南部提供慢性病护理的22个机构。参与者：在研究期间接受全身抗生素治疗的患者。测量：抗生素处方的特点（名称，剂量，持续时间和适应症）和随机选择的患者接受抗生素治疗的临床特征。结果：共有9,373个疗程的抗生素处方为2,408例患者（66%的患者在研究机构）。这些机构的抗生素处方发生率为每1,000患者日2.9至13.9个抗生素疗程。36%的抗生素用于呼吸道感染，33%用于泌尿系感染，13%用于皮肤和软组织感染。在随机选择的1,602名接受抗生素治疗的患者中，49%符合感染的标准化监测定义。分别有58%、28%和65%的处方符合呼吸道、泌尿道和皮肤感染的诊断标准。三分之一的抗生素处方用于泌尿系统适应症是无症状菌尿。不良反应，注意到在6%的处方呼吸道和泌尿系感染和4%的处方皮肤infection.Conclusions：抗生素的使用是频繁的和高度可变的患者谁接受慢性护理。减少无症状菌尿的抗生素处方是优化该人群抗生素使用的重要途径。
Objective: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.Design: A prospective, la-month, observational cohort study.Setting: Twenty-two facilities which provide chronic care in southwestern Ontario.Participants: Patients who were treated with systemic antibiotics over the study period.Measurements: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.Results: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of the patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient-days. Thirty-six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.Conclusions: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population.