意大利治疗非结核分枝杆菌感染的处方习惯和药物可及性:IRENE 研究小组的一项多中心调查。

IF 5.4 2区 医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-09-20 DOI:10.1007/s15010-024-02390-y
Giacomo Stroffolini, Tommaso Lupia, Alberto Gaviraghi, Francesco Venuti, Giacoma Cinnirella, Andrea Gori, Maura Spotti, Francesco Blasi, Luigi Codecasa, Andrea Calcagno, Stefano Aliberti
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引用次数: 0

摘要

目的:非结核分枝杆菌(NTM)造成的临床负担很重,治疗也很困难。此外,非结核分枝杆菌药物在各中心的可及性也不尽相同。这些挑战可能会导致计划外的治疗变更、停药,从而可能影响患者的治疗效果。本调查旨在评估意大利与 IRENE 注册中心(医疗保健专业人员合作网络)相关的中心中,NTM 靶向药物(尤其是氯法齐明)的可及性:2020 年,向意大利 IRENE 网络的 88 位主要调查员发送了一份关于氯法齐明和其他 NTM 靶向药物的使用和供应情况的横断面网络问卷调查。问卷设计了封闭式和开放式问题,并使用 SurveyMonkey® 平台进行分发:调查结果:调查显示,肺科专家(42%)和传染病专家(34%)更多地参与到非淋菌性结核病的治疗策略中。受访者分布在意大利 20 个大区中的 18 个,主要集中在北部,包括大学医院和门诊诊所。40%的相关中心提供分子检测,30%的中心提供表型检测。分别有 10% 和 75% 的中心拥有多学科团队和指定药房服务,负责分配非淋菌药物。在药物的可用性和可及性、药物治疗方案的组成以及药物剂量方面,尤其是氯唑嗪等药物的剂量方面,观察到了很大的差异:这项研究表明,意大利抗 NTM 药物的供应存在很大差异,因此需要统一抗生素处方和获取途径,同时也强调了在确定治疗 NTM 感染的最佳治疗策略方面所面临的挑战。
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Prescription habits and drugs accessibility for the treatment of non-tuberculous mycobacteria infections in Italy: a multicentric survey from the IRENE study group.

Purpose: Non-tuberculous mycobacteria (NTM) account for high clinical burden, and treatment can be challenging. Moreover, accessibility of NTM medications varies across centers. These challenges may lead to unplanned therapeutic changes, discontinuations, potentially affecting patient outcomes. Aim of this survey was to evaluate the accessibility of NTM-targeting drugs in Italy (with a particular focus on clofazimine) in centers associated with the IRENE Registry, a collaborative network of healthcare professionals.

Methods: A cross-sectional, internet-based, questionnaire-survey on the use and availability of clofazimineand other NTM-targeting drugs was sent to 88 principal investigators of the IRENE network in Italyin 2020. The questionnaires were designed with closed-ended and open-ended questions and distributed using the SurveyMonkey® platform.

Results: The surveys underscore the more frequent involvement of pulmonologists (42%) and infectious disease specialists (34%) in NTM treating strategies. Respondents were distributed across 18 out of20 Italian regions, with a significant concentration in the north, encompassing university hospitalsand outpatient clinics. Molecular testing is available in 40% of the involved centers, while phenotypic in 30% of the centers. Centers have a multidisciplinary team and an appointed pharmacy service for NTM drugs distribution in 10 and 75% of the cases, respectively. Substantial variability was observed in drug availability and accessibility, drug regimen composition, and drug dosage, particularly for medications like clofazimine.

Conclusions: This study shows the high heterogeneity of anti-NTM drug availability in Italy and prompts toward a harmonization in antibiotic prescription and access; it also emphasizes the challenges in determining the optimal therapeutic strategies for treating NTM-infections.

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来源期刊
Infection
Infection 医学-传染病学
CiteScore
12.50
自引率
1.30%
发文量
224
审稿时长
6-12 weeks
期刊介绍: Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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