J Am Pharm Assoc (2003). 2021 Sep-Oct;61(5):581-588.e1. doi: 10.1016/j.japh.2021.04.013. Epub 2021 Apr 24.
Antimicrobial consumption has been increasing lately. Hence, effective strategies are required to control antimicrobial use and decrease the development of antimicrobial resistance.
To evaluate the impact of the use of a mobile app on the implementation of antimicrobial stewardship program (ASP) interventions.
This was a longitudinal study conducted at El-Nile Badrawi Hospital in Cairo, Egypt, on inpatients receiving antimicrobials from January 2018 to December 2019. The study included 2 phases: the preimplementation phase, which included a paper-based ASP developed according to the Centers for Disease Control and Prevention Core Elements of Hospital Antibiotic Stewardship Programs 2014, and the mobile app phase where the MEDIcare Pro mobile app was developed and used in ASP intervention implementation. The study outcomes were antimicrobial consumption and cost, length of hospital and intensive care unit (ICU) stay, 30-day mortality rate and readmission rate, and detection of drug-related problems (DRPs).
The mobile app statistically significantly decreased antimicrobial consumption from 75.1 defined daily dose (DDD)/100 bed-days in the preimplementation phase to 64.65 DDD/100 bed-days in the mobile app phase, with a total cost savings of E£1,237,476. There was a significant reduction in the length of ICU stay, with a mean difference of 1.63 days between the 2 phases, but no significance was detected regarding length of hospital stay or readmission rate. There was a statistically significant decrease in mortality rate from 1.17% in the preimplementation phase to 0.83% in the mobile app phase (P = 0.02). The frequency of DRPs detected by pharmacists statistically significantly increased from 0.54/100 bed-days in the preimplementation phase to 3.23/100 bed-days in the mobile app phase.
The use of a mobile app was found to be effective, applicable, and usable in guiding health professionals on rational antimicrobial use.
抗菌药物的使用近来呈上升趋势。因此，需要采取有效的策略来控制抗菌药物的使用，降低抗菌药物耐药性的发展。
评估使用移动应用程序对抗菌药物管理计划（ASP）干预措施实施的影响。
这是在埃及开罗的 El-Nile Badrawi 医院进行的一项纵向研究，研究对象为 2018 年 1 月至 2019 年 12 月期间接受抗菌药物治疗的住院患者。研究包括 2 个阶段：实施前阶段，包括根据 2014 年疾病控制与预防中心医院抗生素管理计划核心要素制定的纸质 ASP；以及移动应用程序阶段，在此阶段开发并使用了 MEDIcare Pro 移动应用程序来实施 ASP 干预措施。研究结果是抗菌药物的消耗和成本、住院和重症监护病房（ICU）停留时间、30 天死亡率和再入院率以及药物相关问题（DRP）的检出率。
移动应用程序在统计学上显著降低了抗菌药物的消耗，从实施前阶段的 75.1 个限定日剂量（DDD）/100 床日降至移动应用程序阶段的 64.65 DDD/100 床日，总成本节约了 1237476 埃镑。ICU 停留时间显著缩短，两个阶段之间的平均差异为 1.63 天，但住院时间或再入院率没有差异。死亡率从实施前阶段的 1.17%显著下降至移动应用程序阶段的 0.83%（P=0.02）。药剂师检出的 DRP 频率从实施前阶段的 0.54/100 床日显著增加至移动应用程序阶段的 3.23/100 床日。
移动应用程序的使用被证明是有效、适用和可用的，可以指导卫生专业人员合理使用抗菌药物。
