老年行为健康人群的抗菌药物管理。
Antimicrobial Stewardship for a Geriatric Behavioral Health Population.
机构信息
Banner Medical University Center South, 2800 E Ajo Way, Tucson, AZ 85713, USA.
University of Arizona College of Pharmacy, 1295 N Martin PO Box 210202, Tucson, AZ 85721-0202, USA.
出版信息
Antibiotics (Basel). 2016 Jan 19;5(1):8. doi: 10.3390/antibiotics5010008.
Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit.
抗菌药物耐药性是一个日益严重的公共卫生问题。抗菌药物管理和多学科干预可以预防不适当的抗菌药物使用并改善患者的护理。特殊人群，尤其是老年人和患有精神健康障碍的患者，特别需要这种干预。本项目的目的是评估药剂师干预对老年精神病学病房（GPU）中抗菌药物处方适当性的影响。在 GPU 住院期间开口服抗生素的年龄≥18 岁的患者被纳入研究。在药剂师干预前后评估抗菌药物的适当性。在干预前和干预后的六个月期间，分别确定了 63 名和 70 名接受抗生素治疗的患者。与干预前组相比，干预后组的指征不适当剂量明显减少（10.6%对 23.9%，p = 0.02），并且抗生素的疗程不适当的情况明显减少（15.8%对 32.4%，p < 0.01）。在适应症合适的药物和肾功能合适的剂量方面，两组之间没有显著差异。在干预后组中，有更多的患者的药物剂量、疗程和适应症得到了适当的处方（51%对 66%，p = 0.04）。药剂师干预与老年精神病学病房中不适当的抗菌药物处方率降低有关。
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