Reed Erica E, West Jessica E, Keating Ellen A, Pancholi Preeti, Balada-Llasat Joan-Miquel, Mangino Julie E, Bauer Karri A, Goff Debra A
Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Division of Infectious Diseases, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Diagn Microbiol Infect Dis. 2014 Feb;78(2):157-61. doi: 10.1016/j.diagmicrobio.2013.11.012. Epub 2013 Nov 15.
Candidemia is associated with significant morbidity, mortality, and hospital cost. We conducted a quasi-experimental study to evaluate the impact of an Antimicrobial Stewardship Program (ASP) pharmacist's interventions on time to effective antifungal therapy, in-hospital mortality, infection-related length of stay (LOS), and costs in patients with candidemia. Patients in 2008 (pre-intervention, n = 85) were compared to those in 2010 (post-intervention, n = 88). Time to effective therapy was significantly faster (median 13.5 versus 1.3 hours, P = 0.04) and was administered to more patients in the post-intervention group [67 (88%) versus 80 (99%), P = 0.008]. There was no significant difference in in-hospital mortality [16 (19%) versus 26 (30%) patients, P = 0.11], infection-related LOS [10 (7-15.5) versus 11 (7-17) days, P = 0.68], or hospital costs during candidemia [$25,697 (15,645-42,870) versus $31,457 ($16,399-83,649), P = 0.25]. ASP pharmacist interventions standardized and improved the quality of care of patients with candidemia.
念珠菌血症与严重的发病率、死亡率及住院费用相关。我们开展了一项准实验研究，以评估抗菌药物管理计划（ASP）药师的干预措施对念珠菌血症患者有效抗真菌治疗时间、院内死亡率、感染相关住院时间（LOS）及费用的影响。将2008年的患者（干预前，n = 85）与2010年的患者（干预后，n = 88）进行比较。干预后组的有效治疗时间显著更快（中位数13.5小时对1.3小时，P = 0.04），且更多患者接受了有效治疗[67例（88%）对80例（99%），P = 0.008]。院内死亡率[16例（19%）对26例（30%）患者，P = 0.11]、感染相关住院时间[10天（7 - 15.5天）对11天（7 - 17天），P = 0.68]或念珠菌血症期间的住院费用[$25,697（15,645 - 42,870美元）对$31,457（16,399 - 83,649美元），P = 0.25]均无显著差异。ASP药师的干预措施规范并提高了念珠菌血症患者的护理质量。
