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抗菌药物管理计划中的药物干预措施与临床结局

[Pharmaceutical interventions and clinical outcomes in an antimicrobial stewardship program].

作者信息

Holguín Héctor, Amariles Pedro, Ospina William, Pinzón Miguel, Granados Johan

机构信息

Clínica Medellín S.A - Quironsalud, Grupo de investigación Promoción y Prevención Farmacéutica, Universidad de Antioquia, Colombia.

Grupo de Investigación Promoción y Prevención Farmacéutica, Universidad de Antioquia, Colombia.

出版信息

Rev Chilena Infectol. 2020 Aug;37(4):343-348. doi: 10.4067/S0716-10182020000400343.

Abstract

BACKGROUND

The pharmacist's participation in the antimicrobial stewardship program (AMSP) has been associated with better outcomes.

AIMS

To describe the pharmaceutical interventions and clinical outcomes of a PGA focused on broad-spectrum antibiotics in hospitalized patients in a tertiary healthcare setting.

METHOD

Prospective observational study in patients admitted to a tertiary healthcare setting between August-2016 and September-2017. In the context of a AMSP, a pharmacist training in infectious diseases evaluated and intervened antibiotic therapy, with the infectious disease specialist, who performed relevant modification of the antibiotic therapy. In addition, the clinical outcome was evaluated and documented.

RESULTS

258 patients were included. 16.1% of antibiotics were assessed as not indicated. A total of 126 pharmaceutical interventions were performed with 82.5% acceptance. The main outcome was the clinical and/or microbiological cure of infection.

CONCLUSION

The problem associated with the antibiotic most frequently in the study population was the antimicrobial spectrum. Being consistent, de-escalation was the pharmaceutical intervention with the highest prevalence. A high percentage of acceptance of the interventions performed by the pharmacist in the environment of the PGAn was considered. Clinical and/or microbiological cure was the main cause of hospital discharge.

摘要

背景

药剂师参与抗菌药物管理计划(AMSP)已与更好的结果相关联。

目的

描述在三级医疗环境中针对住院患者使用广谱抗生素的药剂师主导干预(PGA)的药学干预措施及临床结果。

方法

对2016年8月至2017年9月期间入住三级医疗环境的患者进行前瞻性观察研究。在抗菌药物管理计划背景下,一名接受过传染病培训的药剂师与传染病专科医生一起评估并干预抗生素治疗,传染病专科医生对抗生素治疗进行相关调整。此外,对临床结果进行评估并记录。

结果

纳入258例患者。16.1%的抗生素被评估为无指征。共进行了126次药学干预,接受率为82.5%。主要结果是感染的临床和/或微生物学治愈。

结论

研究人群中与抗生素相关的最常见问题是抗菌谱。持续一致地进行降阶梯治疗是最常见的药学干预措施。药剂师在药剂师主导干预环境中所进行干预的接受率较高。临床和/或微生物学治愈是出院的主要原因。

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