逐步,多模式,非限制性抗菌药物管理计划的长期影响,以减少ICU中广泛抗生素的使用
Mar Ronda1, Victor Daniel Gumucio-Sanguino2,3, Evelyn Shaw1,3,4
1Department of Infectious Diseases, Hospital Universitari de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Antibiotics (Basel, Switzerland)
|February 23, 2024
概括
在ICU的逐步,非限制性抗菌药物管理 (AMS) 计划减少了广谱抗生素的使用,并在八年内改善了处方的适当性. 这项研究提供了关于AMS战略长期影响的见解.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 公共卫生 公共卫生
背景情况:
- 关于非限制性抗微生物管理 (AMS) 策略的长期影响的数据有限.
- 由于高消耗和耐药性风险,重症监护室 (ICU) 是监测抗生素使用的关键设置.
- 评估AMS计划的持续影响对于优化抗生素使用和打击抗菌素耐药性至关重要.
研究的目的:
- 评估一个分阶段,多式,非限制性的AMS计划对ICU中的抗生素使用的长期影响.
- 评估AMS计划对广谱抗生素消费的影响.
- 为了确定抗生素处方适宜性的变化,在八年时间内.
主要方法:
- 一项前性的8年研究 (2011-2019) 涉及在ICU中逐步实施非限制性AMS计划.
- 抗生素使用量是每100个患者日 (PD) 的DDD.
- 月度点患病率调查评估了抗生素处方的适当性;Poisson回归分析了趋势.
主要成果:
- 总体而言,抗生素使用减少了23% (从185.4 DDD/100 PD降至141.9 DDD).
- 广谱抗生素的使用初步增加,随后在2016年后持续每年减少10%.
- 抗生素处方的适当性显著改善,每年增加11% (p=0.048).
结论:
- 一个逐步,多式,非限制性的AMS计划可以实现在ICU中广泛使用抗生素的持续减少.
- 实施的AMS战略显著提高了长期抗生素处方的适当性.
- 这种方法提供了一个可行的模型,可以在没有限制措施的情况下优化在重症监护机构的抗生素使用.
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