通过实施基于计算机的抗菌药物管理干预计划 (ASP) 来优化肺炎住院患者的万科米辛使用
Ashlesha Kaushik1, Brittany Esty2, Corey Thieman3
1Pediatric Infectious Diseases; Pediatrics, UnityPoint Health and University of Iowa Carver College of Medicinehttps://ror.org/05ntqke24, Sioux City, USA.
Infection control and hospital epidemiology
|March 9, 2026
概括
一项基于信息的抗微生物管理干预措施显著降低了肺炎患者的万科米辛使用率,降低了49.5%. 这一举措还将药物成本降低了50%,并将鼻腔MRSAPCR查提高到100%.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
- 医疗信息学 医疗信息学
背景情况:
- 在肺炎中过度使用万科米辛是对抗微生物药物管理计划的担忧.
- 鼻甲素耐药黄金葡萄球菌 (MRSA) 聚合酶链反应 (PCR) 查对肺炎具有很高的负预测价值.
- 疾病控制和预防中心认为,过度使用万科米辛是管理的关键目标.
研究的目的:
- 实施基于信息的抗微生物管理计划 (ASP) 干预.
- 在六个月内将入院肺炎患者的万科米辛使用量减少20%.
主要方法:
- 一个准实验性的设计,比较了干预前 (P1) 和干预后 (P2) 时期.
- 在电子病历中实施自动默认的鼻腔MRSA PCR (nMP) 命令,用于肺炎中的万科米辛订单.
- 在中西部上部的一个三级护理中心的质量改善计划,涉及住院的肺炎患者.
主要成果:
- 范科米辛的使用密度下降了49.5% (72.2至36.3DOT/1000个患者日;p < .0001).
- 范科米辛药物库存成本下降了50% (从1089.5美元降至546.3美元/1000个患者日;p < .0001).
- nMP的订购增加到100% (p < .0001),而在48-72小时内停止使用万科米辛,以获得负面PCR结果,增加到71% (p < .0001).
结论:
- 基于计算机的ASP干预有效地减少了肺炎中的万科米辛利用率.
- 实现了显著的医疗保健成本节省.
- 在肺炎患者中,nMP查的数量大幅增加,证明了干预措施的变革性影响.
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