Zhou Y, Ma L-Y, Zhao X, Tian S-H, Sun L-Y, Cui Y-M
Department of Pharmacy, Peking University First Hospital, Beijing, China.
J Clin Pharm Ther. 2015 Aug;40(4):404-8. doi: 10.1111/jcpt.12275. Epub 2015 Apr 25.
The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at achieving rational use of antibiotics, made pharmacists part of the responsible medical team. Our objective was to describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations.
Pharmacists participated in antibiotic stewardship programmes of the hospital and urological clinical work and conducted real-time interventions at the same time from 2011 to 2013. Data on the use of antibiotics between 2010 and 2013 in urology were collected.
Comparison of the 2013 data with those of 2010 showed that antibiotic use density [AUD= DDDs100/(The number of patients who were treated the same periodAverage days in hospital). DDDs = Total drug consumption (g)/DDD. DDD is the Defined Daily Dose] decreased by 57·8(58·8%); average antibiotic cost decreased by 246·94 dollars; the cost of antibiotics as a percentage of total drug cost decreased by 27·7%; the rate of use of antibiotics decreased from 100% to 7·3%.
The study illustrates how an antibiotic stewardship programme with pharmacist participation including real-time interventions can promote improved antibiotic-prescribing and significantly decrease costs.
2011年以前,在中国清洁手术中预防性使用抗生素是常规做法。随着世界卫生组织在2011年呼吁合理使用抗生素,中国于当年4月启动了一项关于抗生素临床使用的全国专项整治方案。该方案旨在实现抗生素的合理使用,使药剂师成为负责医疗团队的一部分。我们的目的是描述药剂师干预对抗生素使用的影响,特别是在泌尿外科清洁手术中。
2011年至2013年期间,药剂师参与了医院的抗生素管理计划和泌尿外科临床工作,并同时进行实时干预。收集了2010年至2013年泌尿外科抗生素使用的数据。
将2013年的数据与2010年的数据进行比较,结果显示抗生素使用密度【AUD = DDDs * 100 /(同期接受治疗的患者人数 * 平均住院天数)。DDDs = 总药物消耗量(克)/ DDD。DDD是限定日剂量】下降了57.8(58.8%);抗生素平均费用下降了246.94美元;抗生素费用占总药物费用的百分比下降了27.7%;抗生素使用率从100%降至7.3%。
该研究表明,由药剂师参与并包括实时干预的抗生素管理计划如何能够促进抗生素处方的改善并显著降低成本。