澳大利亚医院的抗真菌管理:定义范围和未来目标
Karen F Urbancic1,2,3,4,5, David C M Kong2,6, Paul D R Johnson3,5
1National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Internal medicine journal
|December 2, 2024
概括
澳大利亚医院正在实施抗真菌管理 (AFS) 计划,重点是高成本的静脉注射药物. 主要障碍包括员工的时间和诊断访问,突出了AFS模型需要改进的领域.
科学领域:
- 传染性疾病 传染性疾病
- 医院 医院 药房 医院药房
- 公共卫生 公共卫生
背景情况:
- 抗菌药物管理 (AMS) 准则越来越多地建议抗真菌管理 (AFS) 用于管理侵入性真菌病 (IFD).
- 之前没有关于澳大利亚医院AFS计划的报道.
- 这项研究解决了了解澳大利亚当前AFS实践的差距.
研究的目的:
- 评估澳大利亚医院抗真菌使用监测的现状.
- 确定实施的AFS战略及其目标.
- 确定在AFS实施过程中遇到的障碍.
主要方法:
- 2018年2月,向澳大利亚的公立和私立医院分发了一项定量,横截面的电子调查.
- 用描述性统计数据来分析调查数据.
- 该调查从143家医院获得了58%的响应率,有83名参与者.
主要成果:
- 大多数医院 (75%) 对抗真菌药物的使用进行了监测,主要是跟踪成本和进行年度点流行调查.
- 核心AFS策略,如预先授权 (89%) 和专家处方后审查 (79%) 是常见的,特别是在高成本的静脉注射药物.
- 障碍包括员工时间有限,AFS优先级挑战,以及无法获得快速诊断和治疗药物监测 (TDM) 的机会.
结论:
- 澳大利亚的AFS计划主要针对昂贵的静脉注射抗真菌药物.
- 虽然存在专家监督,但诸如可纳和口服可纳之类的关键药物往往没有被准.
- 解决发现的差距和障碍对于在澳大利亚医院开发有效的AFS模型至关重要.
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