Investigation on antimicrobial usage in 451 patients with complicated intra-abdominal infection
10.3760/cma.j.issn.1671-0282.2019.05.015
- VernacularTitle:451例复杂性腹腔感染患者抗菌药物临床应用状况分析
- Author:
Songgao LOU
1
;
Lingcheng XU
;
Leiqing LI
;
Rongsheng ZHU
;
Jiaojiao SONG
;
Xuanding WANG
Author Information
1. 浙江大学医学院附属第二医院感染管理科
- Keywords:
Complicated;
Intra-abdominal infection;
Antibiotics;
De-escalation;
Antimicrobial stewardship
- From:
Chinese Journal of Emergency Medicine
2019;28(5):609-613
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the microbiological epidemiology and clinical use of antibiotics in patients complicated intra-abdominal infection (cIAI),therefore to optimize antibiotic use and to promote antimicrobial stewardship.Methods A total of 451 patients with cIAI from a Chinese tertiary hospital between January 2015 and December 2016 were retrospectively reviewed.The infection severity,timing of microbiological specimen sampling,culture results,initial antibiotic selection and later anti-infective regimen adjustment were analyzed.Results Three hundred and sixteen (70.1％,316/451) patients undergone microbiological investigation at infection sites within 3 days and 133 (42.1％) patients had a positive culture,of which 64.5％ were Enterobacteriaceae.Three hundred seventy-four patients (82.9％) initially received broad-spectrum antibiotics against gram-negative bacilli.Sixty-five patients (14.4％) initially received combined antibiotic therapy,of which 30.8％ were deemed as overuse.Among 308 patients who initially received broad-spectrum antibiotic therapy,268 patients (87.0％) clinically improved in five days,while de-escalation was only conducted in 72 cases (26.9％).On average,patients were treated with (2.29±1.30) antibiotics for a duration of (10.6±6.5) days,and 42.4％ received combined antibiotic therapy during hospitalization.Conclusions The major microbiological pathogens in cIAI patients in our hospital were Enterobacteriaceae.However,there are phenomena such as excessive usage with broad-spectrum antibiotics,insufficient awareness of de-escalation,and long course of anti-infective therapy,which needs to be further improved.
