Comparative analysis of different anti-infective schemes,efficacy and drug indexes of appendicitis patients with multi-drug resistant bacteria
Objective To investigate whether there were differences in subsequent treatment outcomes among different initial empirical anti-infective treatment regimens,explore the impact of the drug resistance rate of the empirical anti-infective regimens on clinical efficacy and potential replacements for the anti-infective regimens,taking patients with multi-drug resistant bacteria after acute appendicitis resection included in the study.Methods The case data of 138 patients with postoperative appendicitis admitted to the people's hospital of Longhua in Shenzhen from January 2021 to November 2023 were retrospectively analyzed,and they were divided into Group A(cephalosporin),Group B(cefuroxime),and Group C(beta lactam/beta lactam enzyme inhibitor)according to different initial empirical anti-infection regimens.The clinical efficacy,postoperative gastrointestinal function recovery,changes in inflammatory factor test level before and after operation,intensity of antibacterial drug use,DDDs,cost of antibacterial drugs,cumulative number of intravenous infusion bags,etc.,were compared among the three groups.The correlation between drug resistance rate and treatment effect,and the correlation between multi-resistance type and drug change rate of all samples were analyzed.Results There was no statistically significant difference(P>0.05)in clinical efficacy,postoperative gastrointestinal function recovery,and changes in inflammatory cytokine levels before and after surgery among Group A,Group B,and Group C;in terms of the intensity of antibacterial drug use and the number of DDDs,Group A<Group C<Group B;in terms of the number of antimicrobial infusion bags,Group A<Group B<Group C;in terms of antibacterial drug costs and the percentage of antibacterial drug costs to total drug costs,Group B<Group A<Group C,and the above differences were statistically significant(P<0.05);there was no significant correlation between empirical treatment resistance rate and treatment efficacy,and there was no significant correlation between multi-tolerance types of pathogenic bacteria and dressing change rate(P>0.05).Conclusion There is no significant difference in anti-infective efficacy and overall clinical efficacy of cefuroxime,cefuroxime and β-lactam/β-lactam inhibitors in patients with acute appendicitis after operation.The clinical selection of cephalomycin drugs can significantly reduce the intensity of antibacterial drug use in hospital and the cumulative number of intravenous infusion bags,and has the marginal effect of maintaining good antibacterial efficacy while reducing medical costs,which regimen is worthy promoting.
万方数据
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