Wu Lisa Dong-Ying, Walker Sandra A N, Elligsen Marion, Palmay Lesley, Simor Andrew, Daneman Nick
BScPhm, was, at the time of this study, a pharmacy research student in the Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario. She is now with the Department of Pharmacy at West Park Healthcare Centre, Toronto, Ontario.
BSc, BScPhm, PharmD, FCSHP, is with the Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario. She has affiliate status with the Department of Medicine, Division of Infectious Diseases, and Division of Clinical Pharmacology, Sunnybrook Health Sciences Centre; the Sunnybrook Research Institute; and the Leslie L Dan Faculty of Pharmacy, University of Toronto.
Can J Hosp Pharm. 2015 Nov-Dec;68(6):445-9. doi: 10.4212/cjhp.v68i6.1500.
Antimicrobial stewardship may be important in long-term care facilities because of unnecessary or inappropriate antibiotic use observed in these residents, coupled with their increased vulnerability to health care-associated infections.
To assess antibiotic use in a long-term care facility in order to identify potential antimicrobial stewardship needs.
A retrospective descriptive study was conducted at the Veterans Centre, a long-term care facility at Sunnybrook Health Sciences Centre, Toronto, Ontario. All residents taking one or more antibiotics (n = 326) were included as participants. Antibiotic-use data for patients residing in the facility between April 1, 2011, and March 31, 2012, were collected and analyzed.
Totals of 358 patient encounters, 835 antibiotic prescriptions, and 193 positive culture results were documented during the study period. For 36% (302/835) of antibiotic prescriptions, the duration was more than 7 days. Cephalosporins (30%; 251/835) and fluoroquinolones (28%; 235/835) were the most frequently prescribed antibiotic classes. Urine was the most common source of samples for culture (60%; 116/193).
Characteristics of antimicrobial use at this long-term care facility that might benefit from further evaluation included potentially excessive use of fluoroquinolones and cephalosporins and potentially excessive duration of antibiotic use for individual patients.
由于长期护理机构中的居民存在不必要或不适当的抗生素使用情况，再加上他们更容易受到医疗保健相关感染的影响，因此抗菌药物管理在这些机构中可能很重要。
评估一家长期护理机构中的抗生素使用情况，以确定潜在的抗菌药物管理需求。
在安大略省多伦多市桑尼布鲁克健康科学中心的一家长期护理机构退伍军人中心进行了一项回顾性描述性研究。所有服用一种或多种抗生素的居民（n = 326）均被纳入研究对象。收集并分析了2011年4月1日至2012年3月31日期间居住在该机构的患者的抗生素使用数据。
在研究期间，共记录了358次患者诊疗、835张抗生素处方和193份阳性培养结果。在36%（302/835）的抗生素处方中，用药时长超过7天。头孢菌素类（30%；251/835）和氟喹诺酮类（28%；235/835）是最常开具的抗生素类别。尿液是最常见的培养样本来源（60%；116/193）。
该长期护理机构抗菌药物使用的特点可能需要进一步评估，包括氟喹诺酮类和头孢菌素类可能的过度使用以及个别患者抗生素使用时长可能过长。
