在开放式医疗重症监护病房中逐步实施抗菌管理计划:对抗生素利用和临床结果的评估
Si-Ho Kim1, Min-Jin Bae2, Sohui Lee3
1Antimicrobial Stewardship Team, Samsung Changwon Hospital; Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
概括
在ICU中的逐步抗菌管理计划 (ASP) 减少了抗生素的使用和多药耐药生物体的隔离. 医生助理支持的循环证明是可行的,并改善了患者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 重症监护病房 (ICU) 面临着感染和抗菌素耐药性的重大挑战.
- 适当的抗生素使用对脆弱的ICU患者至关重要.
研究的目的:
- 评估逐步抗微生物管理计划 (ASP) 对开放医疗ICU中抗生素利用和临床结果的影响.
主要方法:
- 实施了两阶段的ASP:最初由传染病专家进行基于记录的审查,随后进行包括医生助理 (PA) 在内的循环审查.
- 对比了三个时期的结果:ASP前,基于记录的ASP和基于圆的ASP.
- 测量了抗生素利用率 (DOT/1000患者日),多抗药生物体的隔离,以及ICU死亡率.
主要成果:
- 在研究期间,总体抗生素使用量显著下降.
- 一些特殊的抗生素类别,包括美罗烯姆/伊米烯姆和抗假体β-乳酸盐,显示了利用率的显著降低.
- 在基于记录和基于圆形的ASP阶段之间观察到Acinetobacter baumannii隔离和患者死亡率的减少.
结论:
- 一个逐步的ASP有效地减少了抗生素消耗和多药耐药生物体在ICU环境中的隔离.
- 由PA支持的管理轮是改善ICU结果的可行和有效策略.
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