O'Sullivan Cathal E
Midland Regional Hospitals, Arden Road, Tullamore, Offaly, Ireland.
J Antimicrob Chemother. 2020 May 1;75(5):1087-1090. doi: 10.1093/jac/dkaa006.
There are now 10 years of national antimicrobial consumption data in Ireland. Despite the creation of an 'antimicrobial stewardship and infection control industrial complex' over this period, the data demonstrate a 16% increase in consumption nationally. Given the ongoing challenges with carbapenemase-producing Enterobacterales and Clostridioides difficile within the acute hospital system, the data point to the ineffectiveness of the national antimicrobial stewardship programme/model. A different model of antimicrobial stewardship is therefore needed. This new model is one based around the collection and dissemination of physician-specific consumption, together with greater education of clinicians in the management of infections. By shining a light on individual clinician antibiotic prescribing, outlier identification, along with peer to peer (or clinician to clinician) pressure, can be brought to bear on the problem and shift the emphasis from the current 'policing' oversight, to self-regulation instead.
爱尔兰现在有10年的全国抗菌药物消费数据。尽管在此期间创建了“抗菌药物管理与感染控制产业联合体”，但数据显示全国抗菌药物消费量增长了16%。鉴于急性医院系统中持续存在产碳青霉烯酶肠杆菌科细菌和艰难梭菌的挑战，这些数据表明国家抗菌药物管理计划/模式无效。因此，需要一种不同的抗菌药物管理模式。这种新模式是围绕医生特定消费量的收集和传播建立的，同时加强临床医生在感染管理方面的教育。通过公开个体临床医生的抗生素处方情况，识别异常值，并施加同行（或临床医生之间）压力，可以解决这个问题，并将重点从当前的“监管”监督转向自我监管。
