National Center for Infection Control, Ministry of Health, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Euro Surveill. 2019 Aug;24(34). doi: 10.2807/1560-7917.ES.2019.24.34.1900022.
BackgroundIn 2012, Israel's National Center for Infection Control initiated a national stewardship programme that included mandatory annual reporting of antimicrobial use. Here we present nationwide Israeli data for the period 2012 to 2017.AimThe goal of this study was to detect trends in antimicrobial use in Israel following the introduction of the stewardship programme, as part of an assessment of the programme's impact.MethodsIn this retrospective observational study, data were collected from Israel's health maintenance organisations (HMOs), acute care hospitals and post-acute care hospitals (PACHs). Acute care hospital data were collected for general medical and surgical wards, and medical/surgical intensive care units (ICUs). Data were converted into defined daily doses (DDD), with use rates presented as DDD per 1,000 insured/day in the community and DDD per 100 patient-days in hospitals and PACHs. Trends were analysed using linear regression.ResultsAntimicrobial use decreased across sectors between 2012 and 2017. In the community, the decrease was modest, from 22.8 to 21.8 DDD per 1,000 insured per day (4.4%, p = 0.004). In acute care hospitals, antibiotic DDDs per 100 patient-days decreased from 100.0 to 84.0 (16.0%, p = 0.002) in medical wards, from 112.8 to 94.2 (16.5%, p = 0.004) in surgical wards and from 154.4 to 137.2 (11.1%, p = 0.04) in ICUs. Antimicrobial use decreased most markedly in PACHs, from 29.1 to 18.1 DDD per 100 patient-days (37.8%, p = 0.005).ConclusionBetween 2012 and 2017, antimicrobial use decreased significantly in all types of healthcare institutions in Israel, following the introduction of the nationwide antimicrobial stewardship programme.
背景
2012 年，以色列国家传染病控制中心启动了一项国家管理计划，其中包括强制性的年度抗菌药物使用报告。在此，我们呈现了 2012 年至 2017 年期间以色列全国范围内的相关数据。
目的
本研究旨在检测在管理计划实施后，以色列抗菌药物使用的趋势，以评估该计划的影响。
方法
在这项回顾性观察研究中，数据来自以色列的健康维护组织（HMOs）、急性护理医院和后期护理医院（PACHs）。急性护理医院的数据来自普通内科和外科病房以及内科/外科重症监护病房（ICU）。数据转换为限定日剂量（DDD），社区使用率表示为每 1000 名参保人/天的 DDD，医院和 PACHs 中则表示为每 100 名患者/天的 DDD。采用线性回归分析趋势。
结果
2012 年至 2017 年期间，各部门的抗菌药物使用均呈下降趋势。在社区，这一下降幅度较小，从每天每 1000 名参保人 22.8 DDD 降至 21.8 DDD（4.4%，p=0.004）。在急性护理医院，每 100 名患者/天的抗生素 DDD 从内科病房的 100.0 DDD 降至 84.0 DDD（16.0%，p=0.002）、外科病房的 112.8 DDD 降至 94.2 DDD（16.5%，p=0.004）和 ICU 的 154.4 DDD 降至 137.2 DDD（11.1%，p=0.04）。抗菌药物使用在 PACHs 中下降幅度最大，从每天每 100 名患者 29.1 DDD 降至 18.1 DDD（37.8%，p=0.005）。
结论
自 2012 年国家抗菌药物管理计划实施以来，以色列所有类型的医疗机构的抗菌药物使用均显著下降。
