新型冠状病毒肺炎（COVID-19）大流行对新加坡一家 tertiary 医院抗菌药物的使用和处方的影响。
Effects of coronavirus disease 2019 (COVID-19) pandemic on antimicrobial prevalence and prescribing in a tertiary hospital in Singapore.
机构信息
Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore.
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
出版信息
Antimicrob Resist Infect Control. 2021 Feb 3;10(1):28. doi: 10.1186/s13756-021-00898-8.
BACKGROUND
The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing.
METHODS
One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017-2019.
RESULTS
The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08).
CONCLUSION
During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.
背景
部署抗菌药物管理（AMS）团队应对 COVID-19 大流行可能导致已建立的框架、最佳实践和领导力丧失，从而对抗菌药物处方和耐药性产生不利影响。我们旨在研究 COVID-19 大流行期间减少 AMS 资源对抗菌药物处方的影响。
方法
一名全职当量的 AMS 药剂师被部署来支持大流行工作，与传染病医生的 AMS 查房从每周 5 次减少到 2 次。2020 年 7 月采用全球时点患病率调查方法对急性住院患者进行了调查，并与 2015 年和 2017-2019 年的数据进行了比较。
结果
尽管发生了大流行，但抗菌药物处方（2015 年为 55%，2019 年为 49%，2020 年为 47%，p=0.02）和抗菌药物（2015 年为 54%，2019 年为 45%，2020 年为 42%，p<0.01）的使用率一直在下降。疑似或确诊 COVID-19 病例的传染病病房中抗菌药物的处方率为 2020 年为 29%。总体而言，抗菌药物处方质量指标持续改善（例如，在医嘱中注明用药理由，2015 年为 91%，2019 年为 94%，2020 年为 97%，p<0.01）或保持稳定（符合指南，2015 年为 71%，2019 年为 62%，2020 年为 73%，p=0.08）。
结论
在 COVID-19 大流行期间，抗菌药物处方没有增加，抗菌药物处方质量指标没有显著差异。
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