Štefkovičová M, Litvová S, Meluš V, Krištúfková Z, Bražinová A
Regional Public Health Authority, Trenčín, Slovak Republic; Faculty of Health Care, Alexander Dubček University, Trenčín, Slovak Republic.
Regional Public Health Authority, Trenčín, Slovak Republic.
J Hosp Infect. 2016 Aug;93(4):403-9. doi: 10.1016/j.jhin.2016.02.017. Epub 2016 Mar 3.
Antimicrobial use and resultant resistance is still increasing worldwide. Close monitoring and strict implementation of policies are important to tackle this issue.
To assess the use of antimicrobials in acute care hospitals in the Slovak Republic.
Antimicrobial use was monitored as part of a point prevalence survey (PPS) of healthcare-associated infections. Surveillance was performed in 40 hospitals in the Slovak Republic according to the standardized methodology developed by the European Centre for Disease Prevention and Control. Data were collected according to a standard protocol.
In total, 8397 patients in 40 Slovak hospitals were surveyed. Of these, 30.7% were receiving antibiotics at the time of the survey. In 630 cases, patients were receiving more than one antimicrobial agent. The prevalence of antimicrobial use was highest in intensive care units (54.3%). Antimicrobials were prescribed most frequently for treatment of community-acquired infections (48.1%) and healthcare-associated infections (11.4%). Surgical prophylaxis was the indication for 22.2% of all prescribed antimicrobials, and exceeded 24h in 81.5% of cases. The antimicrobials used most often were fluoroquinolones (20.9%), especially for non-surgical prophylaxis (26.8%) and treatment (21.9%). The antimicrobials prescribed most frequently for surgical prophylaxis were first-generation cephalosporins (23.0%), fluoroquinolones (14.7%) and second-generation cephalosporins (11.4%). The use of antimicrobials was higher in patients with invasive medical devices.
This study found excessive use of broad-spectrum antibiotics, prolonged surgical prophylaxis, frequent use of parenteral antibiotics and inadequate documentation of the indication for prescription. These findings present opportunities for improving the management of antimicrobials in Slovak hospitals.
全球范围内抗菌药物的使用及由此产生的耐药性仍在增加。密切监测和严格执行政策对于解决这一问题至关重要。
评估斯洛伐克共和国急性护理医院中抗菌药物的使用情况。
作为医疗保健相关感染点患病率调查（PPS）的一部分，对抗菌药物的使用进行监测。根据欧洲疾病预防控制中心制定的标准化方法，在斯洛伐克共和国的40家医院进行监测。按照标准方案收集数据。
斯洛伐克40家医院共对8397例患者进行了调查。其中，30.7%的患者在调查时正在接受抗生素治疗。在630例病例中，患者接受了不止一种抗菌药物。重症监护病房的抗菌药物使用率最高（54.3%）。抗菌药物最常用于治疗社区获得性感染（48.1%）和医疗保健相关感染（11.4%）。手术预防是所有开具抗菌药物的22.2%的指征，81.5%的病例超过24小时。最常使用的抗菌药物是氟喹诺酮类（20.9%），特别是用于非手术预防（26.8%）和治疗（21.9%）。手术预防最常开具的抗菌药物是第一代头孢菌素（23.0%）、氟喹诺酮类（14.7%）和第二代头孢菌素（11.4%）。使用侵入性医疗器械的患者抗菌药物使用率更高。
本研究发现存在广谱抗生素使用过度、手术预防时间延长、肠外抗生素频繁使用以及处方指征记录不充分的情况。这些发现为改善斯洛伐克医院抗菌药物管理提供了机会。
