Park Soh Mee, Kim Hyung Sook, Jeong Young Mi, Lee Jung Hwa, Lee Eunsook, Lee Euni, Song Kyoung Ho, Kim Hong Bin, Kim Eu Suk
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Korea.
College of Pharmacy, Seoul National University, Seoul, Korea.
Infect Chemother. 2017 Mar;49(1):31-37. doi: 10.3947/ic.2017.49.1.31. Epub 2017 Mar 13.
Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention.
Data were retrospectively collected by reviewing electronic medical records. All hospitalized patients aged 18 and older who met the study inclusion criteria for the conversion were included between August and November 2015. We computed the physicians' adherence rate to the ASP recommendations. We also measured the total use of fluoroquinolones, length of hospital stay, and medication costs.
During 4 months, 129 cases were enrolled in the study. The adherence rate was 79.8%. The average total prescription volume of intravenous fluoroquinolones, the length of hospital stay, and the total cost of the fluoroquinolones statistically significantly decreased in the intervention-adherent group.
Intervention to facilitate conversion from intravenous to oral administration has reduced excess use of intravenous fluoroquinolones and length of hospital stay. With these findings, further implementations of the ASP extending to other antibiotics may be warranted.
尽早从静脉注射抗生素转换为口服抗生素,在降低导管相关感染风险、减轻护士工作量、降低直接和间接成本以及缩短住院时间方面发挥着重要作用。2015年8月,我院实施了抗菌药物管理计划(ASP),以促进氟喹诺酮类药物从静脉注射转换为口服给药。本研究评估了该干预措施的临床和经济影响。
通过回顾电子病历回顾性收集数据。纳入2015年8月至11月期间所有符合转换研究纳入标准的18岁及以上住院患者。我们计算了医生对ASP建议的依从率。我们还测量了氟喹诺酮类药物的总使用量、住院时间和药物成本。
在4个月期间,129例患者纳入研究。依从率为79.8%。在干预依从组中,静脉注射氟喹诺酮类药物的平均总处方量、住院时间和氟喹诺酮类药物的总成本在统计学上显著降低。
促进从静脉注射转换为口服给药的干预措施减少了静脉注射氟喹诺酮类药物的过度使用和住院时间。基于这些发现,可能有必要进一步将ASP扩展到其他抗生素的应用。