Department of General Medicine, AIIMS, Patna, India.
Department of General Medicine, AIIMS, Patna, India.
Indian J Med Microbiol. 2021 Jul;39(3):349-351. doi: 10.1016/j.ijmmb.2021.03.016. Epub 2021 Apr 8.
Antimicrobial resistance (AMR) is a serious threat to the humanity now a days. To prevent it, the first step is to know about our antibiotic practices. Audit is the first step in continuous quality improvement which intend to go ahead. Antibiotic stewardship involves appropriate antibiotic (empirical or definitive) at correct time in correct doses and frequency for appropriate duration.
We conducted a retrospective study in intensive care unit at our tertiary care center of Bihar, India. Our aim was to know about empirical antibiotic we are prescribing in suspected sepsis patients and their rationality too. National treatment guidelines for infectious disease released by National Centre for Disease Control (NCDC) was taken as standard of care. We recorded demographic profile, SOFA (Sequential Organ Failure Assessment), APACHE II (Acute Physiology and Chronic Health Evaluation), antibiotic prescribed, final etiology of infection, and outcome of the patient and total ICU stay.
We found that combination of two antibiotics were given in majority of patients (53%) and the third generation cephalosporin was the most commonly prescribed antibiotic. In our audit, rational combinations according to the antibiotic policies were given in 73.7% of patients. Appropriate doses of antibiotics were given in 89.5% of patients.
Audit is a mandatory exercise to provide quality care in the health care system.
如今，抗生素耐药性（AMR）对人类构成了严重威胁。为了预防它，首先要了解我们的抗生素使用情况。审核是持续质量改进的第一步，旨在不断推进。抗生素管理涉及在正确的时间、以正确的剂量和频率、在适当的时间内使用适当的抗生素（经验性或确定性）。
我们在印度比哈尔邦的一家三级护理中心的重症监护病房进行了一项回顾性研究。我们的目的是了解疑似败血症患者使用的经验性抗生素及其合理性。国家疾病控制中心（NCDC）发布的国家传染病治疗指南被作为护理标准。我们记录了人口统计学特征、SOFA（序贯器官衰竭评估）、APACHE II（急性生理学和慢性健康评估）、所开抗生素、感染的最终病因以及患者的转归和 ICU 总住院时间。
我们发现，大多数患者（53%）使用了两种抗生素的联合治疗，而第三代头孢菌素是最常开的抗生素。在我们的审核中，根据抗生素政策开出了 73.7%的合理联合用药。89.5%的患者给予了适当剂量的抗生素。
审核是医疗保健系统中提供高质量护理的强制性措施。
