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碳青霉烯类药物的使用与重症监护病房 COVID-19 患者的比例相关。

Carbapenem use correlates with percentage of patients with COVID-19 in intensive care units.

机构信息

King Fahad Military Medical Complex, Dhahran, Saudi Arabia.

Infectious Disease Unit, King Fahad Military Medical Complex, Dhahran, Saudi Arabia.

出版信息

Infection. 2023 Apr;51(2):331-336. doi: 10.1007/s15010-022-01867-y. Epub 2022 Jun 18.

Abstract

BACKGROUND

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 carbapenem consumption and describe the implemented measures during the first year of the COVID-19 pandemic.

METHODS

We calculated carbapenem consumption for all the hospital and for intensive care units (ICU) for three periods: baseline (before COVID-19 cases, January 2019-February 2020), and the period of COVID-19 cases as a pre-intervention (March-August 2020) and a post-intervention phase (September 2020-December 2021).

RESULTS

During the study period, the percentage of admitted COVID-19 patients increased in the months of April-August of 2020 (pre-intervention period) from 5 to 26% of total admitted patients. The consumption of carbapenems (DDD/1000 patient days) increased from a mean of 67.1 at baseline to 142.9 pre-intervention. In ICUS, there was an increase in the mean from 125.7 to 240.8 DDD/1000 patient days. After interventions, the DDD/1000 patient days decreased by 49.5% overall the hospital and by 36% in ICUs. For the post-intervention period, there was a correlation between COVID-19 cases and carbapenem usage in the ICU but not the overall hospital.

CONCLUSION

An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Antimicrobial stewardship programs are essential to reduce consumption rate.

摘要

背景

第一波 COVID-19 大流行可能对医院的抗菌药物使用产生了重大影响。本研究的目的是评估 COVID-19 大流行期间碳青霉烯类药物使用的演变,并描述实施的措施。

方法

我们计算了所有医院和重症监护病房(ICU)在三个时期的碳青霉烯类药物使用量:基线期(COVID-19 病例前,2019 年 1 月至 2020 年 2 月),以及 COVID-19 病例的干预前(2020 年 3 月至 8 月)和干预后(2020 年 9 月至 2021 年 12 月)期。

结果

在研究期间,2020 年 4 月至 8 月(干预前)COVID-19 患者入院比例从总入院患者的 5%增加到 26%。碳青霉烯类药物(DDD/1000 患者天)的消耗量从基线时的平均 67.1 增加到干预前的 142.9。在 ICU 中,平均值从 125.7 增加到 240.8 DDD/1000 患者天。干预后,医院整体 DDD/1000 患者天减少了 49.5%,ICU 减少了 36%。对于干预后时期,ICU 中 COVID-19 病例与碳青霉烯类药物使用之间存在相关性,但医院整体没有相关性。

结论

在第一波 COVID-19 大流行期间,抗菌药物的使用量增加,尤其是在 ICU 中。抗菌药物管理计划对于降低消耗率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b3/9206090/05f2bd697bd2/15010_2022_1867_Fig1_HTML.jpg

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