头孢曲松在学术急诊科的使用:循证使用或过度使用

M. Rezai, Hasan Safehian, P. Hafezimoghadam, H. Amiri, A. Javan
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摘要

背景:目前头孢曲松被广泛使用,但其使用与现行指南的相容性较差。本研究的目的是确定头孢曲松的适当使用。研究结果可能有助于找到防止其在急诊科(ED)不当使用的方法。方法:对两所教学医院2019年9月23日至2020年3月19日转诊急诊科使用头孢曲松治疗的患者进行观察分析。根据最新循证文献确定头孢曲松的合理使用。结果:156例患者正确使用头孢曲松,占38.4%;95% CI, 33.5-42.9%),其余250例患者(69.6%;95% ci, 57.1-66.5%)。头孢曲松的适当使用与目标导向的使用、I级分诊、尿路感染(UTI)的尿液分析(U/A)和肺炎的胸片证据独立相关。结论:本研究揭示了头孢曲松在教学医疗中心的不当使用;因此,在这一领域进一步的教育似乎是必要的。
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The Use of Ceftriaxone in Academic Emergency Departments: Evidence-Based Utilization or Overuse
Background: Nowadays, ceftriaxone is being used widely and its use is less compatible with the current guidelines. The aim of this study was to determine the appropriate use of ceftriaxone. The results may help to find a way to prevent its inappropriate use in the emergency department (ED). Methods: In this observational-analytical study, the patients who were referred to EDs of two teaching hospitals from September 23, 2019, to March 19, 2020, and treated with ceftriaxone were analyzed. The appropriate use of ceftriaxone was determined based on the latest evidence-based literature. Results: Ceftriaxone had been prescribed properly in 156 patients (38.4%; 95% CI, 33.5-42.9%) and its use did not meet logical criteria in the remaining 250 patients (69.6%; 95% CI, 57.1-66.5%). The appropriate use of ceftriaxone was independently related to goal-directed use, level I triage, urinalysis (U/A) indicating urinary tract infection (UTI), and chest radiographic evidence of pneumonia. Conclusion: Our study revealed the inappropriate use of ceftriaxone in teaching medical centers; therefore, further education seems to be necessary in this field.
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