Di Pentima M Cecilia, Chan Shannon, Eppes Stephen C, Klein Joel D
Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, Delaware 19803, USA.
Clin Pediatr (Phila). 2009 Jun;48(5):505-12. doi: 10.1177/0009922808330774. Epub 2009 Feb 17.
Antimicrobial stewardship programs (ASP) are an effective strategy to ensure that antibiotics are used in accordance with scientific evidence to improve patient outcome, minimize antimicrobial (AM) resistance, and reduce hospital costs. The article describes the impact of the implementation of an ASP on AM prescription errors.
Prospective, single-center study performed at a tertiary pediatric teaching hospital that actively monitored 13 targeted AMs (amikacin, amphotericin B, cefepime, ceftriaxone, ciprofloxacin, fluconazole, levofloxacin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole) and microbiology data. The ASP was implemented using CareNet and PharmNet. An infectious disease physician and pharmacist determined the need for intervention.
The authors screened 5564 dispensed prescriptions of the 13 targeted AMs. The rate of AM errors associated with these was 0.09/1000 doses administered and 5 errors/1000 patient days.
Active surveillance and optimization of computerized physician order entry system allows early detection and intervention of AMs prescriptions errors in hospitalized children.
抗菌药物管理计划（ASP）是一种有效的策略，可确保抗生素的使用符合科学依据，以改善患者预后、最大限度地减少抗菌药物（AM）耐药性并降低医院成本。本文描述了实施ASP对AM处方错误的影响。
在一家三级儿科教学医院进行前瞻性单中心研究，积极监测13种目标抗菌药物（阿米卡星、两性霉素B、头孢吡肟、头孢曲松、环丙沙星、氟康唑、左氧氟沙星、利奈唑胺、美罗培南、哌拉西林-他唑巴坦、妥布霉素、万古霉素和伏立康唑）及微生物学数据。使用CareNet和PharmNet实施ASP。由一名传染病医生和一名药剂师确定干预需求。
作者筛查了13种目标抗菌药物的5564张已配药处方。与之相关的AM错误率为每1000剂给药0.09例，每1000患者日5例错误。
对计算机化医嘱录入系统进行主动监测和优化可早期发现并干预住院儿童的AM处方错误。
