Rahem Lydia R, Franck Bénédicte, Roy Hélène, Lebel Denis, Ovetchkine Philippe, Bussières Jean-François
is a candidate for the DPharm degree in the Faculty of Pharmacy, Université de Montréal, Montréal, Quebec. She is also an intern with the Department of Pharmacy, CHU Sainte-Justine, Montréal, Quebec.
is a candidate for the DPharm degree, Université Paul Sabatier, Toulouse, France. She is also a Research Assistant with the Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Quebec.
Can J Hosp Pharm. 2021 Winter;74(1):21-29. Epub 2021 Jan 1.
Antimicrobial stewardship is a standard practice in health facilities to reduce both the misuse of antimicrobials and the risk of resistance.
To determine the profile of antimicrobial use in the pediatric population of a university hospital centre from 2015/16 to 2018/19.
In this retrospective, descriptive, cross-sectional study, the pharmacy information system was used to determine the number of days of therapy (DOTs) and the defined daily dose (DDD) per 1000 patient-days (PDs) for each antimicrobial and for specified care units in each year of the study period. For each measure, the ratio of 2018/19 to 2015/16 values was also calculated (and expressed as a proportion); where the value of this proportion was ≤ 0.8 or ≥ 1.2 (indicating a substantial change over the study period), an explanatory rating was assigned by consensus.
Over the study period, 94 antimicrobial agents were available at the study hospital: 70 antibiotics (including antiparasitics and antituberculosis drugs), 14 antivirals, and 10 antifungals. The total number of DOTs per 1000 PDs declined from 904 in 2015/16 to 867 in 2018/19. The 5 most commonly used antimicrobials over the years, expressed as minimum/maximum DOTs per 1000 PDs, were piperacillin-tazobactam (78/105), trimethoprim-sulfamethoxazole (74/84), ampicillin (51/69), vancomycin (53/68), and cefotaxime (55/58). In the same period, the care units with the most antimicrobial use (expressed as minimum/maximum DOTs per 1000 PDs) were hematology-oncology (2529/2723), pediatrics (1006/1408), and pediatric intensive care (1328/1717).
This study showed generally stable consumption of antimicrobials from 2015/16 to 2018/19 in a Canadian mother-and-child university hospital centre. Although consumption was also stable within drug groups (antibiotics, antivirals, and antifungals), there were important changes over time for some individual drugs. Several factors may explain these variations, including disruptions in supply, changes in practice, and changes in the prevalence of infections. Surveillance of antimicrobial use is an essential component of an antimicrobial stewardship program.
抗菌药物管理是医疗机构的一项标准做法，旨在减少抗菌药物的滥用以及耐药风险。
确定2015/16年至2018/19年期间某大学医院中心儿科人群的抗菌药物使用情况。
在这项回顾性、描述性横断面研究中，利用药房信息系统确定研究期间每年每种抗菌药物以及特定护理单元每1000患者日（PD）的治疗天数（DOT）和限定日剂量（DDD）。对于每项指标，还计算了2018/19年与2015/16年数值的比值（并表示为比例）；若该比例值≤0.8或≥1.2（表明在研究期间有显著变化），则通过共识给出解释性评级。
在研究期间，研究医院有94种抗菌药物可供使用：70种抗生素（包括抗寄生虫药和抗结核药）、14种抗病毒药和10种抗真菌药。每1000 PD的DOT总数从2015/16年的904天降至2018/19年的867天。多年来最常用的5种抗菌药物，以每1000 PD的最低/最高DOT表示，分别是哌拉西林 - 他唑巴坦（78/105）、甲氧苄啶 - 磺胺甲恶唑（74/84）、氨苄西林（51/69）、万古霉素（53/68）和头孢噻肟（55/58）。同期，抗菌药物使用量最高的护理单元（以每1000 PD的最低/最高DOT表示）是血液肿瘤科（2529/2723）、儿科（1006/1408）和儿科重症监护室（1328/1717）。
本研究表明，2015/16年至2018/19年期间，加拿大一家母婴大学医院中心的抗菌药物总体消耗量稳定。尽管各药物组（抗生素、抗病毒药和抗真菌药）内的消耗量也稳定，但一些个别药物随时间有重要变化。几个因素可能解释这些差异，包括供应中断、实践变化和感染患病率变化。抗菌药物使用监测是抗菌药物管理计划的重要组成部分。
