对包括计算机化药物利用评估在内的多方面干预措施的前性准实验性研究,以改善抗生素管理计划
Sunudtha Suksamai1, Sirinporn Sajak2, Kanokporn Thongphubeth2
1From the Department of Internal Medicine, Faculty of Medicine, Thammasat University.
Journal of patient safety
|February 19, 2024
概括
多方面的干预措施显著减少了抗生素使用和药物利用评估 (DUE) 错误. 这导致了抗卡巴因的Enterobacteriaceae感染的减少,改善了患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 医院 医院 药房 医院药房
- 抗微生物药物管理委员会
背景情况:
- 抗生素耐药性是一个日益严重的全球健康问题.
- 抗生素管理计划 (ASP) 对于优化抗生素使用至关重要.
- 提高ASP的有效性需要持续的评估和干预.
研究的目的:
- 评估旨在加强抗生素管理计划 (ASP) 的多方面的干预措施.
- 评估这些干预措施对减少整体抗生素消费的影响.
- 确定对药物利用评估 (DUE) 填表表格和感染率错误的影响.
主要方法:
- 采用了前性的准实验性研究设计.
- 干预措施包括通过计算机化DUE预授权,自我监督的检查清单和主动提醒.
- 数据是在第三级护理中心的预干预 (2018) 和后干预 (2019-2020) 期间收集的.
主要成果:
- 总体抗生素使用的显著减少 (867.68对732.33中位数DDD/1000个睡觉日;P<0.001).
- 广泛使用抗生素的显著下降,包括美罗和胆固醇.
- 在DUE表格填写错误 (40%与28%相比;P<0.001) 和耐卡巴耐药Enterobacteriaceae发病率 (0.27与0.12/1000个睡眠日相比;P=0.02) 的实质性降低.
结论:
- 与ASP整合的多方面的干预措施有效地减少了广谱抗生素的使用.
- 这些干预措施导致了DUE填写表格错误的显著减少.
- 观察到抗卡巴胺 Enterobacteriaceae 感染/殖民的显著减少.
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