抗菌药物处方不合理对COVID-19患者治疗预后及生存的影响

IF 0.2 Q4 ANESTHESIOLOGY Anaesthesia, Pain & Intensive Care Pub Date : 2021-11-25 DOI:10.25284/2519-2078.4(97).2021.248405
A. Kotliar, S. Dubrov, S. Sereda, M. Denisyuk, G. Ponyatovska
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摘要

IIntroduction。COVID-19大流行成为世界各地卫生保健系统面临的重大挑战。新冠肺炎患者基础治疗方法的发展和完善,对改善公众健康、提高康复后生活质量具有重要意义。本研究的目的是:确定COVID-19患者院前和住院阶段抗菌药物的使用频率和结构。评估不合理使用抗菌药物与冠状病毒病患者住院时间、转入重症监护病房(ICU)风险和死亡率的关系。材料和方法:对2020年9月至2021年11月期间在市非营利企业“基辅市17号临床医院”(KNP“KMKL#17”)治疗的400例COVID-19患者的病例史进行统计和回顾性分析。结果:选取400张病历进行研究,根据抗菌治疗目的分为两组。在接受院前抗菌治疗的患者组(200人)中,其预约指征仅占7%。在接受抗菌药物治疗的患者中,住院时间延长,转至ICU的风险增加。与院前未开抗菌药物的2组患者(8%)相比,1组患者的死亡率(14.5%)也更高。结论:本研究发现,不合理给予抗菌药物治疗的患者一般住院时间延长2.3±0.8天,恶化患者转至ICU的需要平均增加13%,抗生素相关性腹泻发生率增加7- 8%,COVID-19死亡率有增加的趋势。由SARS-CoV-2引起的呼吸道疾病患者,经证实存在细菌共感染(重复感染)或有合理怀疑时,应根据适应证使用抗菌药物,在任何情况下均不得使用预防性药物。
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INFLUENCE OF IRRATIONAL PRESCRIPTION OF ANTIBACTERIAL THERAPY ON THE PROGNOSIS OF TREATMENT AND SURVIVAL IN PATIENTS WITH COVID-19
IIntroduction. The COVID-19 pandemic became a major challenge for healthcare systems around the world. The development and improvement of basic treatments for coronavirus patients is important to improve public health and improve quality of life after recovery. The aim of the study: to determine the frequency and structure of prescribing antibacterial drugs in the prehospital and hospital stages, used in patients with COVID-19. Assess the relationship between irrational use of antibacterial drugs with the length of hospital stay of patients with coronavirus disease, the risk of transfer to the intensive care unit (ICU) and mortality. Materials and methods: Statistical, retrospective analysis of 400 case histories of patients with COVID-19 who were treated at the Municipal Non-Profit Enterprise «Kyiv City Clinical Hospital №17» (KNP «KMKL#17») for the period from September 2020 to November 2021 with severe coronavirus disease. Results: 400 medical charts were selected for the study, which were divided into two groups according to the purpose of antibacterial therapy. Of the group of patients who received pre-hospital antibacterial therapy (200 people), indications for its appointment had only 7 % of patients. Among the group receiving antibacterial drugs there is a prolongation of the length of stay in the hospital, the risk of transfer to ICU increases. There is also higher risk of mortality in patients of group 1 (14,5 %), compared with group 2 (8 %), whose antibacterial drugs were not prescribed at the prehospital stage. Conclusion: as a result of the study it was found that patients who were unreasonably prescribed antibacterial therapy prolongs the period of general hospitalization by 2.3 ± 0.8 days, increasing the need for transfer of patients due to deterioration to ICU by an average of 13 %, increase in the incidence of antibiotic-associated diarrhea by 7-8 %, and there is a tendency to increase mortality from COVID-19. Antibacterial drugs should be used only on the basis of indications in the case of proven bacterial co-infection (superinfection) or reasonable suspicion of it in patients with respiratory disease caused by SARS-CoV-2 and in no case should be prophylactic.
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0.00%
发文量
56
审稿时长
4 weeks
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