重症肺炎抗菌药物管理指导护理模式的开发和评估：一项回顾性队列研究
Development and evaluation of an antimicrobial stewardship-guided nursing care model for severe pneumonia: A retrospective cohort study.
摘要(中文译文)
重症肺炎与高死亡率和大量抗菌药物暴露相关。不恰当的抗菌药物使用会促进抗菌药物耐药和药物不良反应，可能使结局恶化。旨在为重症肺炎患者开发并评价一种抗菌药物管理指导下的护理照护模式。在中国人民解放军总医院第二医学中心（中国北京）开展了一项单中心回顾性队列研究。回顾了2024年6月至2025年6月期间收治的重症肺炎患者的病历资料。2024年6月至12月收治的患者接受常规护理，而2025年1月至6月收治的患者接受抗菌药物管理指导下的护理模式。结局评估至出院或第28天，以先发生者为准。与常规护理相比，抗菌药物管理指导组表现出更高的标本采集依从性和抗菌药物选择合理性评分，以及更低的药物利用指数（DUI）、限定日剂量（DDDs）和核心抗菌药物不恰当使用（均p<0.05）。临床治愈率更高，住院时间和炎症标志物恢复时间更短，并发症发生率更低（均p<0.05）。护理质量和患者满意度评分也得到改善（p<0.001）。抗菌药物管理指导下的护理照护模式与重症肺炎患者抗菌药物使用质量改善、抗菌药物相关并发症减少以及临床和护理结局更好相关；然而，因果推断受到非同期回顾性设计的限制。
Abstract
Severe pneumonia is associated with high mortality and substantial antimicrobial exposure. Inappropriate antimicrobial use contributes to antimicrobial resistance and adverse drug reactions, potentially worsening outcomes. To develop and evaluate an antimicrobial stewardship-guided nursing care model for patients with severe pneumonia. A single-center retrospective cohort study was conducted at the Second Medical Center of Chinese People's Liberation Army General Hospital (Beijing, China). Medical records of patients with severe pneumonia admitted between June 2024 and June 2025 were reviewed. Patients admitted in June-December 2024 received routine nursing care, whereas those admitted in January-June 2025 received a stewardship-guided nursing model. Outcomes were assessed until discharge or day 28, whichever occurred first. Compared with routine care, the stewardship-guided cohort showed higher specimen collection compliance and antimicrobial selection rationality scores and lower drug utilization index (DUI), defined daily doses (DDDs) and inappropriate use of core antimicrobials (all p<0.05). Clinical cure rate was higher, length of stay and inflammatory-marker recovery time were shorter and complication rates were lower (all p<0.05). Nursing quality and patient satisfaction scores also improved (p<0.001). An antimicrobial stewardship-guided nursing care model was associated with improved antimicrobial-use quality, reduced antimicrobial-related complications and better clinical and nursing outcomes in patients with severe pneumonia; however, causal inference is limited by the non-concurrent retrospective design.
如何引用
AMA
Dongze Peng, Jing Fu, Simin Song. Development and evaluation of an antimicrobial stewardship-guided nursing care model for severe pneumonia: A retrospective cohort study.. Pakistan journal of pharmaceutical sciences. 2026; doi:10.36721/PJPS.2026.39.6.164.1.
APA
Dongze Peng, Jing Fu, Simin Song (2026). Development and evaluation of an antimicrobial stewardship-guided nursing care model for severe pneumonia: A retrospective cohort study.. Pakistan journal of pharmaceutical sciences. https://doi.org/10.36721/PJPS.2026.39.6.164.1
GB/T 7714
Dongze Peng, Jing Fu, Simin Song. Development and evaluation of an antimicrobial stewardship-guided nursing care model for severe pneumonia: A retrospective cohort study.[J]. Pakistan journal of pharmaceutical sciences, 2026 doi:10.36721/PJPS.2026.39.6.164.1.
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