Usefulness of antibiogram surveillance for methicillin-resistant Staphylococcus aureus in outpatient pediatric populations
Usefulness of antibiogram surveillance for methicillin-resistant Staphylococcus aureus in outpatient pediatric populations
复制标题
DOI：
10.1016/j.diagmicrobio.2008.12.016
复制
发表时间：
2009-05-01
影响因子：
2.9
通讯作者：
Klevens, R. Monina
中科院分区：
文献类型：
--
作者：
McGregor, Jessina C.;Dumyati, Ghinwa;Klevens, R. Monina
我们评估了分发门诊年龄特异性耐甲氧西林金黄色葡萄球菌(MRSA)抗生素图谱对内科医生了解MRSA流行率和选择经验性治疗的影响。对125名来自纽约州门罗县儿科门诊的医生进行了问卷调查，在分配抗生素前和分配后(应答率分别为42%和24%)。医生估计的MRSA患病率的中位数(在金黄色葡萄球菌皮肤感染中)在他们接受抗生素图谱之前为15%，在接受抗生素后为20%。根据抗生素图谱，2005年皮肤感染的真实流行率为25%。当被要求为皮肤脓肿的儿科门诊患者选择经验性治疗时，假设MRSA患病率不同，大多数人在假设患病率为20%或更低时选择头孢氨苄，当患病率假设为30%或更高时选择甲氧苄氨嘧啶-磺胺甲恶唑。这些数据表明，抗生素图谱可能通过增加对当地门诊患者抗生素耐药性流行的了解来改善经验性治疗决策。(C)2009 Elsevier Inc.保留所有权利。
We assessed the impact of distributing an outpatient age-specific methicillin-resistant Staphylococcus aureus (MRSA) antibiogram on physician knowledge of MRSA prevalence and choice of empiric therapy. Questionnaires were given to 125 physicians at outpatient pediatric clinics in Monroe County, NY, before and after antibiogram distribution (response rates, 42% and 24%, respectively). The median physician-estimated MRSA prevalence (among S. aureus skin infections) was 15% before they received the antibiogram and 20% after. According to the antibiogram, the true 2005 prevalence was 25% among skin infections. When asked to select empiric therapy for a pediatric outpatient with a skin abscess, while assuming varying levels of MRSA prevalence, most selected cephalexin when the prevalence was assumed to be 20% or less, and trimethoprim-sulfamethoxazole when the prevalence was assumed to be 30% or greater. These data suggest that antibiograms may improve empiric therapy decision making by increasing knowledge of local outpatient prevalence of antibiotic resistance. (C) 2009 Elsevier Inc. All rights reserved.