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[计算机辅助、药剂师主导的抗菌药物管理计划在感染管理中的有效性]

[Effectiveness of a Computer-facilitated, Pharmacist-driven Antimicrobial Stewardship Program for Infection Management].

作者信息

Ohashi Kengo, Matsuoka Tomoko, Shinoda Yasutaka, Yoshida Shinya, Arai Kaori, Kato Misa, Mori Takayuki, Yoshimura Tomoaki

机构信息

Department of Pharmacy, Ogaki Municipal Hospital.

出版信息

Yakugaku Zasshi. 2017;137(5):643-650. doi: 10.1248/yakushi.16-00245.

Abstract

In recent years, hospitals have routinely implemented antimicrobial stewardship (AS) programs, and it is important that these programs are effective. Consequently, we utilized a customized computer system to support infection management and implemented a pharmacist-driven AS program in our hospital. Using this computer system, a pharmacist monitored the daily usage of carbapenems and agents against anti-methicillin-resistant Staphylococcus aureus and generated a patient database. With the use of this computer system, we found that the patient database entry time significantly decreased from 24 to 12 min (p<0.01). Subsequently, we were also able to monitor tazobactam/piperacillin usage owing to the increased efficiency of our AS program. As a result, the average number of monitored patients significantly increased from 51 to 72 per month (p<0.01) and the number of proposed prescriptions increased from 189 to 238 per year. Additionally, the usage of carbapenems and tazobactam/piperacillin significantly decreased (p<0.01) after implementation of this computer support system. In summary, we recommend that pharmacists utilize computer systems to implement AS programs because they increase the efficiency of interventions and monitoring of patients and promote appropriate antibiotic use.

摘要

近年来,医院常规实施抗菌药物管理(AS)计划,确保这些计划的有效性很重要。因此,我们利用定制的计算机系统支持感染管理,并在我院实施了由药剂师主导的AS计划。通过该计算机系统,药剂师监测碳青霉烯类药物和抗耐甲氧西林金黄色葡萄球菌药物的每日使用情况,并建立了患者数据库。使用该计算机系统后,我们发现患者数据库录入时间从24分钟显著减少至12分钟(p<0.01)。随后,由于我们的AS计划效率提高,我们还能够监测哌拉西林/他唑巴坦的使用情况。结果,每月监测的患者平均数量从51例显著增加至72例(p<0.01),每年提出的处方数量从189份增加至238份。此外,在实施该计算机支持系统后,碳青霉烯类药物和哌拉西林/他唑巴坦的使用量显著下降(p<0.01)。总之,我们建议药剂师利用计算机系统实施AS计划,因为它们提高了干预和患者监测的效率,并促进了抗生素的合理使用。

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