Uda Atsushi, Shigemura Katsumi, Kitagawa Koichi, Osawa Kayo, Onuma Kenichiro, Inoue Shigeaki, Kotani Joji, Yan Yonmin, Nakano Yuzo, Nishioka Tatsuya, Yano Ikuko, Miyara Takayuki, Fujisawa Masato
Department of Infection Control and Prevention, Kobe University Hospital, Kobe 650-0017, Japan.
Department of Pharmacy, Kobe University Hospital, Kobe 650-0017, Japan.
Antibiotics (Basel). 2020 Feb 6;9(2):63. doi: 10.3390/antibiotics9020063.
Antimicrobial stewardship teams (ASTs) have been well-accepted in recent years; however, their clinical outcomes have not been fully investigated in urological patients. The purpose of this study was to evaluate the outcomes of intervention via a retrospective review of urological patients, as discussed in the AST meetings, who were treated with broad-spectrum antibiotics between 2014 and 2018 at the Department of Urology, Kobe University Hospital in Japan. Interventions were discussed in AST meetings for patients identified by pharmacists as having received inappropriate antibiotic therapy. The annual changes in numbers of inappropriate medications and culture submissions over five years at the urology department were statistically analyzed. Among 1,033 patients audited by pharmacists, inappropriate antibiotic therapy was found in 118 cases (11.4%). The numbers of inappropriate antibiotic use cases and of interventions for indefinite infections had significantly decreased during the study period ( = 0.012 and = 0.033, respectively). However, the number of blood and drainage culture submissions had significantly increased ( = 0.009 and = 0.035, respectively). Our findings suggest that urologists have probably become more familiar with infectious disease management through AST intervention, leading to a decrease in inappropriate antibiotic use and an increase in culture submissions.
近年来，抗菌药物管理团队（ASTs）已被广泛接受；然而，其在泌尿外科患者中的临床效果尚未得到充分研究。本研究的目的是通过回顾性分析日本神户大学医院泌尿外科2014年至2018年间接受广谱抗生素治疗的泌尿外科患者（如AST会议中所讨论的）的干预效果。药师确定接受了不适当抗生素治疗的患者，其干预措施在AST会议中进行了讨论。对泌尿外科五年内不适当用药数量和培养送检数量的年度变化进行了统计分析。在药师审核的1033例患者中，发现118例（11.4%）存在不适当的抗生素治疗。在研究期间，不适当抗生素使用病例数和不确定感染的干预数显著减少（分别为=0.012和=0.033）。然而血培养和引流液培养送检数量显著增加（分别为=0.009和=0.035）。我们的研究结果表明泌尿外科医生可能通过AST干预对传染病管理更加熟悉，从而导致不适当抗生素使用减少和培养送检增加。
