Antibiotic use in patients admitted with acute exacerbations of chronic obstructive pulmonary disease
Antibiotic use in patients admitted with acute exacerbations of chronic obstructive pulmonary disease
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DOI：
10.1034/j.1399-3003.1999.13d23.x
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发表时间：
1999-04-01
影响因子：
24.3
通讯作者：
Woodhead, MA
中科院分区：
文献类型：
--
作者：
Smith, JA;Redman, P;Woodhead, MA
本报告的目的是记录的模式，初始抗生素处方在急性加重的慢性阻塞性肺疾病（COPD）在医院setting.All发作的急性加重的COPD，由入院医生诊断，在一家医院在1996年1月至5月期间，被确定。回顾性分析病例记录，排除影像学肺炎、支气管扩张和住院编码错误的病例。记录了症状、微生物培养和初始抗生素治疗，确定了159例患者发作，排除了40例，产生了119例样本。19例病例记录不可用，留下100例（84%）发作的样本。80例患者入院时接受抗生素治疗;阿莫西林是最常见的处方药，有46例（58%）发作。在抗生素治疗组中，42例（53%）患者接受双重治疗，最常见的是大环内酯类抗生素与阿莫西林或头孢菌素。22例（28%）采用静脉治疗。12例（15%）静脉给药持续时间>48 h。从55例患者发作中共分析了76份痰液样本：34份（45%）培养阳性。在15例（27%）患者中，根据培养结果改变或制定了抗生素治疗方案，这些数据表明，抗生素治疗并不是最佳的，抗生素的过度使用，特别是静脉和双重治疗。
The objective of this report was to document the pattern of initial antibiotic prescribing in acute exacerbations of chronic obstructive pulmonary disease (COPD) in a hospital setting.All episodes of acute exacerbation of COPD, as diagnosed by the admitting doctor, in one hospital in the period January to May 1996, were identified. Case notes were reviewed retrospectively Cases of radiographic pneumonia, bronchiectasis and incorrectly coded admissions were excluded. Symptoms, microbial cultures and initial antibiotic therapies were recorded.One hundred and fifty-nine patient episodes were identified; 40 were excluded yielding a sample of 119. Nineteen case notes were unavailable leaving a sample of 100 (84%) episodes. Eighty were treated with antibiotics on admission; amoxycillin was the most frequently prescribed, in 46 (58%) episodes. Of the antibiotic treated group, 42 (53%) patients were given dual therapy most commonly a macrolide antibiotic with either amoxycillin or a cephalosporin. Intravenous treatment was used in 22 (28%) cases. The duration of intravenous treatment was >48 h in 12 (15%) cases. A total of 76 sputum samples were analysed fi om 55 patient episodes: 34 (45%) were culture positive. In 15 (27%) patient episodes, antibiotic therapy was changed or instituted on the basis of culture results.These data suggest that antibiotic treatment is not optimal, with overuse of antibiotics, especially intravenous and dual therapy.