Department of Pharmacy, St. Joseph Medical Center, Bellingham, WA 98225, USA.
J Clin Pharm Ther. 2013 Oct;38(5):401-4. doi: 10.1111/jcpt.12079. Epub 2013 Jul 12.
Antimicrobial stewardship programmes (ASPs) have been shown to decrease antimicrobial resistance, reduce hospital-acquired infections and decrease overall antimicrobial expenditures. At St. Joseph Medical Center in Bellingham, WA, a thrice-weekly ASP was initiated in 2010 with the goals of decreasing carbapenem, fluoroquinolone and vancomycin use and tailoring duration of therapy.
Antibiotic use per 1000 patient-days and carbapenem, fluoroquinolone and vancomycin use were evaluated pre- and post-implementation of the ASP. Total antimicrobial expenditures were evaluated for the 3 years prior to ASP implementation and three years following implementation.
Antimicrobial days of therapy per 1000 patient-days declined by 6·4% after implementation of our ASP. There was a 37% reduction in total antimicrobial expenditures after implementation. Carbapenems, vancomycin and levofloxacin use decreased considerably. Ciprofloxacin use increased during the same time period.
A thrice-weekly, pharmacist-driven ASP can decrease antimicrobial expenditure, shorten duration of therapy and decrease the utilization of carbapenems, vancomycin and levofloxacin.
抗菌药物管理计划 (ASPs) 已被证明可降低抗菌药物耐药性、减少医院获得性感染并降低总体抗菌药物支出。在华盛顿州贝灵汉的圣约瑟夫医疗中心，2010 年启动了一项每周三次的 ASP，目标是减少碳青霉烯类、氟喹诺酮类和万古霉素的使用，并调整治疗时间。
在实施 ASP 前后，评估了每千名患者天的抗生素使用量以及碳青霉烯类、氟喹诺酮类和万古霉素的使用量。在实施 ASP 之前的 3 年和之后的 3 年，评估了总抗菌药物支出。
实施 ASP 后，每千名患者天的治疗抗菌药物天数减少了 6.4%。实施后，总抗菌药物支出减少了 37%。碳青霉烯类、万古霉素和左氧氟沙星的使用量大幅减少。同时期环丙沙星的使用量增加。
每周三次、由药剂师驱动的 ASP 可以降低抗菌药物支出、缩短治疗时间并减少碳青霉烯类、万古霉素和左氧氟沙星的使用。
