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首页> 外文期刊>Critical care : >Standard operating procedures for antibiotic therapy and the occurrence of acute kidney injury: a prospective, clinical, non-interventional, observational study
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Standard operating procedures for antibiotic therapy and the occurrence of acute kidney injury: a prospective, clinical, non-interventional, observational study

机译：抗生素治疗和急性肾损伤发生的标准操作程序：前瞻性，临床，非干预性观察研究

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IntroductionAcute kidney injury (AKI) occurs in 7% of hospitalized and 66% of Intensive Care Unit (ICU) patients. It increases mortality, hospital length of stay, and costs. The aim of this study was to investigate, whether there is an association between adherence to guidelines (standard operating procedures (SOP)) for potentially nephrotoxic antibiotics and the occurrence of AKI.MethodsThis study was carried out as a prospective, clinical, non-interventional, observational study. Data collection was performed over a total of 170?days in three ICUs at Charité – Universitaetsmedizin Berlin. A total of 675 patients were included; 163 of these had therapy with vancomycin, gentamicin, or tobramycin; were >18?years; and treated in the ICU for >24?hours. Patients with an adherence to SOP >70% were classified into the high adherence group (HAG) and patients with an adherence of <70% into the low adherence group (LAG). AKI was defined according to RIFLE criteria. Adherence to SOPs was evaluated by retrospective expert audit. Development of AKI was compared between groups with exact Chi2-test and multivariate logistic regression analysis (two-sided P <0.05).ResultsLAG consisted of 75 patients (46%) versus 88 HAG patients (54%). AKI occurred significantly more often in LAG with 36% versus 21% in HAG (P?=?0.035). Basic characteristics were comparable, except an increased rate of soft tissue infections in LAG. Multivariate analysis revealed an odds ratio of 2.5-fold for LAG to develop AKI compared with HAG (95% confidence interval 1.195 to 5.124, P?=?0.039).ConclusionLow adherence to SOPs for potentially nephrotoxic antibiotics was associated with a higher occurrence of AKI.Trial registrationCurrent Controlled Trials ISRCTN54598675. Registered 17 August 2007.
机译：简介急性肾损伤（AKI）发生在7％的住院患者和66％的重症监护病房（ICU）患者中。它增加了死亡率，住院时间和费用。这项研究的目的是调查对潜在肾毒性抗生素的遵守指南（标准操作程序（SOP））与AKI的发生之间是否存在关联。方法这项研究是作为一项前瞻性，临床，非干预性方法进行的，观察研究。在Charité–柏林大学医学院的三个ICU中进行了总共170天的数据收集。总共包括675名患者;其中有163人接受万古霉素，庆大霉素或妥布霉素治疗;年满18岁？并在ICU中治疗超过24小时。依从性> 70％的患者分为高依从性组（HAG）和依从性<70％的患者分为低依从性组（LAG）。 AKI是根据RIFLE标准定义的。通过回顾性专家审核评估对SOP的遵守情况。比较两组间AKI的发生情况，并进行精确的Chi2检验和多因素Logistic回归分析（双向P <0.05）。结果LAG包括75例患者（46％）和88例HAG患者（54％）。 LAG中AKI发生的频率显着更高，为36％，而HAG中为21％（P≤0.035）。基本特征是可比较的，除了LAG中软组织感染的发生率增加。多变量分析显示LAG发生AKI的机率比HAG高2.5倍（95％置信区间1.195至5.124，P <= 0.039）。结论对潜在肾毒性抗生素的SOP依从性较低与AKI发生率较高相关审判注册电流对照审判ISRCTN54598675。 2007年8月17日注册。

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