Walia Kamini, Ohri V C, Mathai Dilip
Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
Indian J Med Res. 2015 Aug;142(2):130-8. doi: 10.4103/0971-5916.164228.
A survey was conducted to ascertain practice of antimicrobial stewardship programme (AMSP) in India for 2013. A total of 20 health care institutions (HCI) responded to a detailed questionnaire. All the institutions contacted were tertiary care HCI, of which 12 were funded by government (GHCI) and 8 were corporate/private HCI (PHCI). Further, all catered to both rural and urban populations and were spread across the country. Written documents were available with 40 per cent for AMSP, 75 per cent for hospital infection control (HIC) and HIC guidelines and 65 per cent for antimicrobial agents (AMA) prescription guidelines. Records were maintained for health care associated infections (HCAI) by 60 per cent HCI. Antimicrobial resistance (AMR) data were being analysed by 80 per cent HCI. AMA usage data were analysed by only 25 per cent HCI and AMA prescription audit and feedback by 30 per cent. PHCI performed better than GHCI across all fields of AMSP. The main contributory factor was possibly the much higher level of accreditation of PHCI hospitals and their diagnostic laboratories. The absence of infectious diseases physicians and clinical pharmacists is worrying and demands careful attention.
为确定2013年印度抗菌药物管理计划(AMSP)的实施情况进行了一项调查。共有20家医疗机构(HCI)回复了一份详细问卷。所有被联系的机构均为三级医疗HCI,其中12家由政府资助(政府HCI),8家为企业/私立HCI(私立HCI)。此外,所有机构均服务于农村和城市人口,且分布在全国各地。40%的机构有AMSP的书面文件,75%有医院感染控制(HIC)及HIC指南的书面文件,65%有抗菌药物(AMA)处方指南的书面文件。60%的HCI对医疗保健相关感染(HCAI)进行记录。80%的HCI对耐药性(AMR)数据进行分析。仅25%的HCI分析AMA使用数据,30%分析AMA处方审核及反馈。在AMSP的所有领域,私立HCI的表现均优于政府HCI。主要促成因素可能是私立HCI医院及其诊断实验室的认证水平高得多。传染病医生和临床药师的短缺令人担忧,需要予以密切关注。