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荷兰长期护理机构抗菌药物使用监测。

Surveillance of antimicrobial use in Dutch long-term care facilities.

作者信息

Roukens Monique, Verhoef Linda, Stobberingh Ellen, Natsch Stephanie

机构信息

Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.

National Institute for Public Health and the Environment (RIVM)/CIb, Bilthoven, The Netherlands.

出版信息

J Antimicrob Chemother. 2017 May 1;72(5):1516-1520. doi: 10.1093/jac/dkw581.

Abstract

OBJECTIVES

: Residents living in a long-term care facility (LTCF) are more susceptible to infections. Treatment with antimicrobials is sometimes necessary; however, antibiotic use is considered one of the most important drivers of the development of antibiotic resistance. Surveillance data on antibiotic use in these LTCFs are necessary to get more insight into these patterns. The objective of this study was to describe antibiotic use in LTCFs in the Netherlands.

METHODS

: One hundred and seventy-seven LTCFs in the Netherlands were contacted and asked to participate in a study concerning antibiotic resistance and antibiotic use. Associated pharmacies were asked to provide data about systemic antibiotic use for each participating LTCF location over 1 year. Results on antibiotic use are reported here.

RESULTS

: Antibiotic use data from 96 LTCFs were collected from the pharmacies, and 68 of these LTCFs completed additional questionnaires on general characteristics of their location. Mean total use of systemic antimicrobials was 73 DDDs/1000 residents per day (range 2-197 DDDs/1000 residents per day). Co-amoxiclav (23 DDDs/1000 residents/day, range 0-70) was used the most, followed by nitrofurantoin derivatives (12 DDDs/1000 residents/day, range 0-38) and fluoroquinolones (12 DDDs/1000 residents/day, range 0-52). Statistical analysis revealed no significant correlations between the LTCF characteristics and the level of antibiotic use.

CONCLUSIONS

There was a high use of broad-spectrum antimicrobials, with a large variation in total antibiotic use between individual locations. Further analysis of more in-depth data and possible influencing factors is needed.

摘要

目的

居住在长期护理机构(LTCF)的居民更容易感染。有时需要使用抗菌药物进行治疗;然而,抗生素的使用被认为是抗生素耐药性发展的最重要驱动因素之一。获取这些长期护理机构抗生素使用的监测数据对于更深入了解这些模式很有必要。本研究的目的是描述荷兰长期护理机构中的抗生素使用情况。

方法

联系了荷兰的177家长期护理机构,邀请它们参与一项关于抗生素耐药性和抗生素使用的研究。要求相关药房提供每个参与的长期护理机构地点1年期间全身用抗生素使用的数据。此处报告抗生素使用结果。

结果

从药房收集了96家长期护理机构的抗生素使用数据,其中68家长期护理机构完成了关于其地点一般特征的补充问卷。全身用抗菌药物的平均总使用量为每天73 DDDs/1000居民(范围为2 - 197 DDDs/1000居民/天)。阿莫西林克拉维酸(23 DDDs/1000居民/天,范围为0 - 70)使用最多,其次是呋喃妥因衍生物(12 DDDs/1000居民/天,范围为0 - 38)和氟喹诺酮类(12 DDDs/1000居民/天,范围为0 - 52)。统计分析显示长期护理机构特征与抗生素使用水平之间无显著相关性。

结论

广谱抗菌药物使用量大,各机构之间的抗生素总使用量差异很大。需要进一步分析更深入的数据和可能的影响因素。

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