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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Outcomes in Documented Pseudomonas aeruginosa Bacteremia Treated with Intermittent IV Infusion of Ceftazidime, Meropenem, or Piperacillin-Tazobactam: A Retrospective Study
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Outcomes in Documented Pseudomonas aeruginosa Bacteremia Treated with Intermittent IV Infusion of Ceftazidime, Meropenem, or Piperacillin-Tazobactam: A Retrospective Study

机译：用干扰IV输注的CeTtazidime，梅洛尼姆或Piperacillin-Tazobactam治疗的文献后的铜绿假单胞菌菌血症的结果：回顾性研究

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Background: Pseudomonas aeruginosa, one of the leading causes of nosocomial gram-negative bloodstream infections, is particularly difficult to treat because of its multiple resistance mechanisms combined with a lack of novel antipseudomonal antibiotics. Despite knowledge of time-dependent killing with β-lactam antibiotics, most hospitals in Canada currently administer β-lactam antibiotics by intermittent rather than extended infusions. Objectives: To determine clinical outcomes, microbiological outcomes, total hospital costs, and infection-related costs for patients with P. aeruginosa bacteremia who received intermittent IV administration of antipseudomonal β-lactam antibiotics in a tertiary care institution. Methods: For this retrospective descriptive study, data were collected for patients who were admitted between March 1, 2005, and March 31, 2013, who had P. aeruginosa bacteremia during their admission, and who received at least 72 h of treatment with ceftazidime, meropenem, or piperacillin—tazobactam. Clinical and microbiological outcomes were determined, and total and infection-related hospital costs were calculated. Results: A total of 103 patients were included in the analysis, of whom 79 (77%) experienced clinical cure. In addition, bacterial eradication was achieved in 41 (87%) of the 47 patients with evaluable data for this outcome. Twenty-eight (27%) of the 103 patients died within 30 days of discontinuation of antipseudomonal β-lactam antibiotic therapy. The median total cost of the hospital stay was $121 718, and the median infection-related cost was $29 697. Conclusions: P. aeruginosa bacteremia is a clinically significant nosocomial infection that continues to cause considerable mortality and health care costs. To the authors' knowledge, no previous studies have calculated total and infection-related hospital costs for treatment of P. aeruginosa bacteremia with intermittent infusion of antipseudomonal β-lactam antibiotics, with characterization of cost according to site of acquisition of the infection. This study may provide important baseline data for assessing the impact of implementing extended-infusion β-lactam therapy, antimicrobial stewardship, and infection control strategies targeting osa infection in hospitalized patients.
机译：背景：假单胞菌铜绿假单胞菌，是医院革兰阴性血流感染的主要原因之一，特别是由于其多重抗性机制与缺乏新的抗癫痫抗生素相结合。尽管了解β-内酰胺抗生素的时间依赖性杀伤，但加拿大的大多数医院目前通过间歇而不是延长的输注来施用β-内酰胺抗生素。目的：用于确定接受间歇性IV施用抗癫痫β-内酰胺抗生素的P.铜绿假单胞菌菌血症患者的临床结果，微生物结果，医院总成本和相关的感染相关成本。方法：对于此回顾性描述性研究，为2005年3月1日至2013年3月31日入院的患者收集数据，他在入院期间患有P.铜绿假单胞菌菌血症，并收到至少72小时的头孢他啶治疗，梅洛涅姆，或哌拉西林 - 塔沙漠酰胺。确定了临床和微生物结果，并计算了总和感染相关的医院费用。结果：分析中共有103名患者，其中79例（77％）临床治愈。此外，在47名患者的47名患者中实现了细菌根除，为此结果进行了评估数据。 103例患者的二十八（27％）在停止抗癫痫β-内酰胺抗生素治疗后30天内死亡。医院住宿的中位数为121美元718美元，中位数相关的费用为29.697美元。结论：P.铜绿假单胞菌菌血症是一种临床显着的医院感染，持续造成相当大的死亡率和医疗保健费用。向作者的知识，没有先前的研究已经计算出与间歇输注抗癫痫β-内酰胺抗生素的P.铜绿假单胞菌菌治疗的总和感染相关的医院成本。本研究可以提供重要的基线数据，用于评估实施延长输注β-内酰胺治疗，抗微生物管道和感染控制策略在住院患者中靶向OSA感染的影响。

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