Gardiner Sharon J, Pryer Jane A, Duffy Eamon J
Antimicrobial Stewardship Pharmacist, Departments of Pharmacy, Infectious Diseases and Clinical Pharmacology, Canterbury District Health Board.
Senior Advisor, Protection Regulation and Assurance, Ministry of Health.
N Z Med J. 2017 Jul 7;130(1458):27-41.
To determine what antimicrobial stewardship (AMS) practices exist in New Zealand public hospitals.
A quantitative survey based on recommended components of hospital AMS programmes was sent to the 20 DHBs in June 2016.
Ten of the 20 DHBs had an AMS committee, nine had dedicated AMS pharmacist full-time equivalents (FTEs) and eight had lead clinician FTEs. Only one DHB met FTE recommendations for AMS pharmacists and two for clinicians (0.3 and 0.1 FTEs per 100 acute beds, respectively). All DHBs had conducted at least one antimicrobial audit in the preceding 12 months, most had their own antimicrobial guidelines (19/20) and prescribing policies (18/20), and 12 reported on antimicrobial usage by at least one metric (eg, defined daily doses). Staff education on AMS had been given at most DHBs in the previous year, but only three reported having AMS ward rounds. All DHBs had surveillance programmes for resistant organisms and most produced antibiograms (16/20). All reported barriers to implementation of an AMS programme.
Hospital AMS programmes are in their infancy in New Zealand, with wide variation in practices seen. National co-ordination is required to assist DHBs in developing effective programmes to improve antimicrobial use.
确定新西兰公立医院存在哪些抗菌药物管理（AMS）措施。
2016年6月，基于医院AMS项目推荐组成部分开展了一项定量调查，并发送给20个地区卫生委员会（DHBs）。
20个DHBs中有10个设有AMS委员会，9个有专职AMS药剂师全职等效人员（FTEs），8个有牵头临床医生FTEs。只有1个DHB达到了AMS药剂师的FTE建议标准，2个达到了临床医生的标准（每100张急性病床分别为0.3和0.1 FTEs）。所有DHBs在过去12个月内至少进行了一次抗菌药物审计，大多数有自己的抗菌药物指南（19/20）和处方政策（18/20），12个至少通过一种指标（如限定日剂量）报告了抗菌药物使用情况。上一年，大多数DHBs都开展了AMS员工教育，但只有3个报告有AMS查房。所有DHBs都有耐药菌监测项目，大多数生成了抗菌谱（16/20）。所有都报告了实施AMS项目的障碍。
新西兰医院的AMS项目尚处于起步阶段，措施差异很大。需要进行全国协调，以协助DHBs制定有效的项目来改善抗菌药物的使用。
