ABSTRACT
Objective To investigate de-escalation of empiric broad-spectrum antibiotics treatment for patients in intensive care unit (ICU).Methods Data of the patients discharged from ICU in the Second Affiliated Hospital of Zhejiang University from July 1 to December 31 of 2012 and from July 1 to December 31 of 2013 were retrospectively reviewed.Patients with initial use of empirical broad-spectrum antibiotics within 3 d after ICU admission were included in the study.Clinical data including status of infection,the initial empiric antimicrobial therapy,pathogens culture and adjustment of antibiotics in 5 days were analyzed.Results A total of 841 patients were discharged from ICU during the study periods and antibiotics were used in 786 (93.5％) patients.Among 786 patients,389 (49.5％) were treated empirically with broad-spectrum antibiotics,but only 269 (69.2％) had evidences of bacterial infections.Of the 389 patients with empiric antibiotics use,de-escalation of antibiotics was applied only in 6 (1.54％) patients within 5 days after the initiation of treatment.In 269 patients with evidence of infection,specimen sampling and culture were performed in 248 (92.2％) patients within 3 days,among which 165 samples were positive,and the clinical isolates were mainly multi-drug resistant gram negative bacilli and colonized bacteria in oropharyngeal cavity.De-escalation was applied only in 4 (1.49％,4/269) patients with evidences of bacterial infections.Conclusion Broad-spectrum antibiotics as initial empiric therapy is common for patients in ICU,however de-escalation of empiric therapy is rarely applied even in patients with positive results in pathogen isolation and culture.
ABSTRACT
Objective To study the possibility of measuring health status for residents in rural areas by the Chinese SF-36 scale. Methods Health status for 207 residents in rural areas of Fuyang city who were 14 years old and over was measured by the Chinese SF-36 scale. The reliability and validity were analyzed. Results The internal consistency reliability coefficients (Cronbach'α) exceeded 0.50 for all scales except SF and RE scales. Inter-scale correlation coefficients were lower than Cronbach'α coefficients for all scales except SF scale. Factor analysis identified three principal components, which could be used to explain 64.6% of the total variance. The differences of scale scores between the young group and the middle age group weren't significant. There weren't significant differences of scale scores between sexes except RP scale. The differences of scale scores between smokers and no-smokers, drinkers and no-drinkers weren't significant. Nor were the differences between various educational levels. Conclusion Whether the Chinese SF-36 scale is suitable for measurement of health status for residents in rural areas needs further studies to give more evidences.