优化出院抗生素处方:社区医院药剂师主导干预措施的多中心评估
Kaylee E Caniff1, Nicholas Rebold2, Nathan Richards3
1Anti-infective Research Lab, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and Department of Pharmacy Practice, College of Pharmacy, Ferris State University, Grand Rapids, MI, USA.
概括
药剂师的干预显著改善了社区医院的出院抗生素适宜性. 这提高了在重症监护过渡期间的抗菌药物管理,使患者和公共卫生受益.
科学领域:
- 药房实践 在药房实践.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 出院的抗生素处方往往不受医院抗菌药物管理计划的监控.
- 处方经常与临床指南不一致,影响患者的治疗结果和公共健康.
- 药剂师的专业知识可以优化出院时的抗生素处方.
研究的目的:
- 评估药剂师主导的干预对放弃抗生素处方的适当性的影响.
- 评估药剂师建议对临床结果的影响.
- 确定医疗团队对药剂师干预的接受率.
主要方法:
- 一个多中心,准实验性研究,比较干预前后组.
- 药剂师审查,记录和传达标准化的排放抗生素建议.
- 主要结局:整体排放抗生素的适当性 (持续时间,药剂,剂量). 二次结果:药物不良事件,再入院,感染复发.
主要成果:
- 包括4家社区医院的157名患者.
- 干预后,适当的抗生素处方显著增加 (50.0% vs 21.8%,P < 0.001).
- 药剂师的干预被接受了63.1%的时间;没有观察到临床结果的显著差异.
结论:
- 一个由药剂师驱动的干预显著改善了放出抗生素处方的适当性.
- 这突出了药剂师在抗菌药物管理中的关键作用.
- 在护理转型中优化抗生素的使用有利于个体患者和公共卫生.
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