Department of Clinical Pharmacy and Pharmacology, Rak College of Pharmaceutical Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Pharmacy Department, Abdullah Bin Omran Hospital for Obstetrics & Gynecology, Ministry of Health and Prevention, Ras Al Khaimah, United Arab Emirates.
Sci Rep. 2021 Jan 13;11(1):1042. doi: 10.1038/s41598-020-80219-y.
Antibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months' prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient's data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.
抗生素滥用是导致全球抗生素耐药性的一个主要因素。然而，只有少数研究报告了海湾合作委员会国家实施和评估抗菌药物管理计划的情况。本研究在 8 个月的时间内进行，旨在评估新实施的抗菌药物管理计划对改善阿联酋二级保健医院手术抗生素预防用药处方实践的效果，方法是发布当地医院指南。在预先设计的患者情况表中记录了 493 名患者的数据，比较和分析了抗菌药物管理计划实施前（A 期）和后（B 期）两个月清洁和清洁污染手术的手术抗生素预防用药处方实践。在 A 期分析了 347 名患者的数据（PD），在 B 期分析了 146 名 PD。在 A 期，所有手术预防抗生素处方中哌拉西林/他唑巴坦的处方比例从 2.4%降至 B 期的 0%。抗菌药物治疗的适宜性在预防性抗生素的选择（p=0.552）和首剂给药时间（p=0.061）方面，A 期和 B 期之间无显著差异。总符合率从 45.3%略有下降（P=0.08）至 40.2%。总体而言，指南改善了手术前抗生素的处方实践。然而，通过启动周期性审核策略的教育干预，可以进一步提高。
