Service des maladies infectieuses et tropicales, CHU Nancy, hôpitaux de Brabois, bâtiment P. Canton, rue du Morvan, Vandœuvre-Lès-Nancy, Nancy, France.
Med Mal Infect. 2011 Oct;41(10):532-9. doi: 10.1016/j.medmal.2011.08.001. Epub 2011 Sep 9.
The authors report the results of a 15-year antibiotic stewardship policy in the Nancy Teaching Hospital and assess the impact of reinforcing this policy on antibiotic consumption.
Antibiotic stewardship policy was initiated in the mid 90s and then reinforced from 2006 onwards. It was completed by prescription guidelines, nominative prescription of antibiotics, and an operational infectious diseases team (OIDT). The objectives were to promote antibiotic stewardship and decrease the use of extended broad spectrum or costly molecules and intravenous administration. Antibiotics consumption, as defined daily dose per 1000 patient days (DDD/1000PD) and in euros, was monitored from 2005 onwards.
Between 2005 and 2008, overall yearly cost of antibiotics dropped by 34% (-€1,308,902) and consumption in DDD/1000PD by 10%. This drop in consumption concerned all antibiotic classes. Teicoplanin prescription dropped by more than 50% and use of fluoroquinolone IV decreased by 15% in 3years. The operational team's interventions were effective since nearly 80% of suggested prescription amendments were accepted by prescribers.
This experiment shows that it is possible to implement antibiotic stewardship policy. Our results prove a significant decrease in overall consumption of antibiotic, a change in prescribing patterns, with a shift towards the use of cheaper antibiotics.
作者报告了 15 年抗生素管理政策在南锡教学医院的实施结果，并评估了加强该政策对抗生素消耗的影响。
抗生素管理政策于 90 年代中期开始实施，并于 2006 年起加强。该政策通过处方指南、抗生素的指名处方和一个运作中的传染病团队（OIDT）来实施。目标是促进抗生素管理，并减少广谱或昂贵分子的使用和静脉注射。从 2005 年开始，监测抗生素消耗，定义为每 1000 个患者天的定义日剂量（DDD/1000PD）和以欧元计。
在 2005 年至 2008 年期间，抗生素的总年费用下降了 34%（-€1,308,902），DDD/1000PD 消耗下降了 10%。这种消耗的下降涉及所有抗生素类别。替考拉宁的处方下降了 50%以上，氟喹诺酮类药物的静脉注射用量在 3 年内减少了 15%。由于几乎 80%的建议处方修改都被医生接受，因此该运作团队的干预是有效的。
这项实验表明，实施抗生素管理政策是可行的。我们的结果证明了抗生素总消耗的显著下降，处方模式的改变，以及更倾向于使用更便宜的抗生素。
