A review of antimicrobial control strategies in hospitalized and ambulatory pediatric populations.
A review of antimicrobial control strategies in hospitalized and ambulatory pediatric populations.
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住院和门诊儿科人群抗菌控制策略的回顾。
DOI：
10.1097/inf.0b013e3180593170
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Saiman,Lisa
中科院分区：
文献类型：
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作者：
Patel,SameerJ;Larson,ElaineL;Kubin,ChristineJ;Saiman,Lisa
抗生素耐药性是医疗保健中日益严重的危机。已经使用了各种抗微生物管理策略来控制抗生素的使用，以努力减少抗生素耐药性。我们对儿科环境中的抗菌药物管理计划进行了系统评价。28项已发表的研究符合纳入标准。大多数研究（28项中的21项）具有积极的结果，但只有6项测量了干预措施对抗菌素耐药性的影响。针对特定诊断（如中耳炎）的处方医生教育是门诊环境中最有效的干预措施。辅助实验室检查（如病毒病原体快速诊断检测）在住院患者中最有效。大多数研究具有中度至高度偏倚风险，主要是因为选择偏倚、时间序列分析的干预前数据不足以及治疗组之间的污染。迄今为止，评估儿科环境中抗菌药物管理的研究数量有限，并且这些研究设计异质。因此，很难确定最有效的干预措施。未来的研究应旨在克服当前出版物中遇到的偏见。
Antimicrobial resistance is a growing crisis in healthcare. Various antimicrobial stewardship strategies have been used to control antibiotic use in efforts to reduce antibiotic resistance. We conducted a systematic review of antimicrobial stewardship programs in pediatric settings. Twenty-eight published studies met inclusion criteria. The majority (21 of 28) of studies had positive outcomes, but only 6 measured the impact of interventions on antimicrobial resistance. Prescriber education for a specific diagnosis (eg, otitis media) was the most effective intervention in the outpatient setting. Ancillary laboratory tests (eg, rapid diagnostic assays for viral pathogens) were most effective in the inpatient setting. Most studies had moderate to high risk of bias, mainly because of selection bias, inadequate preintervention data for time series analysis, and contamination between treatment groups. To date, there are a limited number of studies assessing antimicrobial stewardship in pediatric settings and these have heterogeneous study designs. Thus, it is difficult to determine the most effective interventions. Future studies should be designed to overcome the biases encountered in current publications.