Pérez Adriana, Dennis Rodolfo J, Rodríguez Benigno, Castro Amparo Y, Delgado Victor, Lozano Juan Manuel, Castro Maria Clara
Clinical Epidemiology and Biostatistics Unit, Pontificia Universidad Javeriana, Bogotá, Colombia.
J Clin Epidemiol. 2003 Oct;56(10):1013-20. doi: 10.1016/s0895-4356(03)00163-x.
A University-based hospital in Bogotá, Colombia, developed and implemented an educational intervention to complement a new structured antibiotic order form. This intervention was performed after assessing the appropriateness of the observed antibiotic prescribing practices using a quasi-experimental study. An application of interrupted time series intervention analysis was conducted in three antibiotic groups (aminoglycosides, cephradine/cephalothin, and ceftazidime/cefotaxime) and their hospital weekly rate of incorrect prescriptions before and after the intervention. A fourth time series was defined on prophylactic antibiotic use in elective surgery. Preintervention models were used in the postintervention series to test for pre-post series level differences. An abrupt constant change was significant in the first, third, and fourth time series indicating a 47, 7.3, and 20% reduction of incorrect prescriptions after the intervention. We conclude that a structured antibiotic order form, coupled with graphic and educational interventions can improve antibiotic use in a university hospital.
哥伦比亚波哥大的一家大学附属医院开发并实施了一项教育干预措施,以补充新的结构化抗生素处方单。这项干预措施是在使用准实验研究评估观察到的抗生素处方行为的合理性之后进行的。对三个抗生素组(氨基糖苷类、头孢拉定/头孢噻吩和头孢他啶/头孢噻肟)及其干预前后医院每周不正确处方率进行了中断时间序列干预分析。第四个时间序列定义为择期手术中预防性抗生素的使用。干预后系列使用干预前模型来测试前后系列水平差异。在第一个、第三个和第四个时间序列中,突然的恒定变化具有显著性,表明干预后不正确处方减少了47%、7.3%和20%。我们得出结论,结构化抗生素处方单,再加上图表和教育干预措施,可以改善大学医院的抗生素使用情况。