Department of Pediatrics & Department of Pharmacy, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an, China/Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou, China.
Department of Pediatrics & Department of Pharmacy, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an, China/Department of Drug and Equipment, Aeromedicine Identification and Training Center of Air Force, 1 Huaqing Road, Xi'an, China.
Pak J Pharm Sci. 2020 May;33(3(Special)):1389-1395.
Antibiotics are widely prescribed and often used irrationally in Chinese hospitals. This study aimed to evaluate the pharmacist's influence on antibiotic use in the pediatric ward. We conducted this pre-to-post intervention study in the pediatrics of a Chinese tertiary hospital. The patients hospitalized from April to June 2018 were assigned to the pre-intervention group and those from April to June 2019 were distributed to post-intervention group. In the post-intervention stage, the pharmacist took measures to promote rational use of antibiotics and their effects were assessed. This study analyzed data of 1408 patients totally, 671 and 737 in the pre-intervention and post-intervention group respectively. The interventions of clinical pharmacist significantly reduced the rate of using antibiotics without indications (from 33.55% to 15.82%, p<0.01), percentage of inappropriate antibiotic choice (from 24.79% to 16.58%, p p<0.01), dose (from 8.55% to 4.34%, p p<0.05), combination (from 11.75% to 5.10%, p p<0.01) and prolonged duration (from 14.53% to 10.46%, p p<0.05). The mean antibiotic cost and cost/patient-day were also significantly reduced after the intervention. The ratio of average antibiotic cost saving to pharmacist time cost was 16.77:1. The pharmacist could play vital roles in optimizing antibiotic use, thus resulting in favorable clinical and economic outcomes in pediatric ward.
抗生素在中国医院被广泛开具和不合理使用。本研究旨在评估药师对儿科病房抗生素使用的影响。我们在中国一家三级医院的儿科进行了这项预-后干预研究。2018 年 4 月至 6 月住院的患者被分配到预干预组,2019 年 4 月至 6 月住院的患者分配到后干预组。在后干预阶段,药师采取措施促进抗生素的合理使用,并评估其效果。本研究共分析了 1408 例患者的数据,其中预干预组 671 例,后干预组 737 例。临床药师的干预显著降低了无指征使用抗生素的比例(从 33.55%降至 15.82%,p<0.01)、不合理选择抗生素的比例(从 24.79%降至 16.58%,p<0.01)、剂量(从 8.55%降至 4.34%,p<0.05)、联合用药(从 11.75%降至 5.10%,p<0.01)和延长疗程(从 14.53%降至 10.46%,p<0.05)。干预后,抗生素的平均费用和每患者-天费用也显著降低。平均抗生素节省费用与药师时间成本的比值为 16.77:1。药师可以在优化抗生素使用方面发挥重要作用,从而在儿科病房产生有利的临床和经济结果。