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新冠疫情第一波期间抗菌药物使用情况的演变

Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic.

作者信息

Grau Santiago, Echeverria-Esnal Daniel, Gómez-Zorrilla Silvia, Navarrete-Rouco Maria Eugenia, Masclans Joan Ramon, Espona Merce, Gracia-Arnillas Maria Pilar, Duran Xavier, Comas Merce, Horcajada Juan Pablo, Ferrández Olivia

机构信息

Pharmacy Department, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Parc de Salut Mar, Passeig Maritim 25-29, 08003 Barcelona, Spain.

Medicine Department, Campus UAB, Bellaterra, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Barcelona, Spain.

出版信息

Antibiotics (Basel). 2021 Jan 29;10(2):132. doi: 10.3390/antibiotics10020132.

Abstract

The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period : A retrospective quasi-experimental before-after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance ( = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/β-lactamase inhibitors or triazoles during April-May was noticed. In the ICU, these findings were more evident, namely ceftriaxone ( = 0.029), carbapenems ( = 0.002), daptomycin ( = 0.002), azithromycin ( = 0.030), and linezolid ( = 0.011) but followed a similar temporal pattern. : An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes.

摘要

新型冠状病毒肺炎(COVID-19)大流行的第一波可能对医院抗菌药物的使用产生了重大影响。本研究的目的是评估这一时期抗菌药物使用的变化情况:在一家西班牙三级护理医院进行了一项回顾性前后对照的准实验研究。该研究比较了两个时期:2018年1月至2020年2月的大流行前时期,以及2020年3月至6月的COVID-19大流行期间。每月以限定日剂量(DDD)/100床日为单位分析抗菌药物的使用情况,并评估医院和重症监护病房(ICU)的总体使用情况。注意到医院的使用量有所增加。虽然只有头孢洛林达到统计学显著性(P = 0.014),但在大多数研究的抗菌药物中都观察到了使用量的上升。检测到明显的时间模式。3月期间观察到头孢曲松和阿奇霉素的使用量增加,4月至5月期间发现达托霉素、碳青霉烯类、利奈唑胺、头孢洛林、新型头孢菌素/β-内酰胺酶抑制剂或三唑类药物的使用量增加。在ICU中,这些发现更为明显,即头孢曲松(P = 0.029)、碳青霉烯类(P = 0.002)、达托霉素(P = 0.002)、阿奇霉素(P = 0.030)和利奈唑胺(P = 0.011),但遵循类似的时间模式。:注意到在COVID-19大流行的第一波期间抗菌药物使用量增加,尤其是在ICU。提供更新的方案和抗菌药物管理计划对于优化这些结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8e1/7911440/786c9a3b1a12/antibiotics-10-00132-g001.jpg

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