住院患者抗菌药物过敏史评估的最佳证据总结

Summary of best evidence for antimicrobial allergy assessment in hospitalized patients

目的检索、评价和汇总住院患者抗菌药物过敏史评估的最佳证据,为护理临床实践提供循证支持。方法系统检索UpToDate、BMJ Best Practice、美国国立指南库、国际指南协作网、中国医脉通指南网、JBI Evidence Synthesis、Cochrane Library、CINAHL、Embase、PubMed、Web of Science、中国知网、万方数据库、维普数据库、中国生物医学文献数据库以及相关协会网站中抗菌药物过敏评估相关的临床决策、指南、专家共识、证据总结、系统评价和Meta分析,检索时限均为建库至2024年9月。由经过循证培训的2名研究员独立筛选文献并进行质量评价,经循证研究小组讨论,对符合标准的文献进行资料提取和证据整合。结果最终纳入8篇文献,包括指南6篇、系统评价2篇。总结出抗菌药物过敏评估重要性、过敏评估对象、过敏评估人员、过敏评估内容、过敏史记录、评估注意要点6个方面25条证据。结论医护人员在应用和转化证据时,应充分考虑临床实际情况,探索具有本土特色的住院患者抗菌药物过敏史评估方案,提升住院患者抗菌药物过敏史评估准确性,从而加强用药安全管理,提升合理用药水平。

Objective To search for,assess,and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients,so as to provide an evidence-based basis for clinical nursing practice.Methods UpToDate,BMJ Best Practice,National Guideline Clearinghouse,Guidelines International Network,Yimaitong,JBI Evidence Synthesis,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,China National Knowledge Infrastructure,Wanfang Data,CQVIP,SinoMed,and related association websites were searched by computer for literature about clinical decisions,guidelines,expert consensuses,evidence summaries,systematic reviews and metaanalyses related to antimicrobial allergy assessment in hospitalized patients.The search time limit was from the establishment of the databases to September 2024.Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently.Finally,the evidence-based research group extracted and integrated the evidence after discussion.Results Totally 8 articles were involved,including 6 guidelines and 2 systematic reviews.Finally,25 pieces of best evidence were obtained across 6 aspects,including the importance of antimicrobial allergy assessment,the subjects of allergy assessment,the personnel conducting allergy assessment,the content of allergy assessment,the recording of allergy history,and assessment tips.Conclusion When applying and transforming evidence,medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics,to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients,so as to strengthen the safety management of drug use and improve the level of rational drug use.