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[在一所母子大学医院中,根据世界卫生组织基本药物清单(AWaRe)分类对抗生素使用演变情况的探索]

[Exploration of the evolution of antibiotic consumption according to the WHO AWaRe classification, in a mother-child university hospital].

作者信息

Bleuse A, Chabut C, Roy H, Lebel D, Ovetchkine P, Blackburn J, Bussières J-F

机构信息

Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.

Département de pédiatrie, CHU Sainte-Justine, Montréal, QC, Canada.

出版信息

Ann Pharm Fr. 2022 Jul;80(4):576-583. doi: 10.1016/j.pharma.2021.08.012. Epub 2021 Sep 2.

DOI:10.1016/j.pharma.2021.08.012
PMID:34481782
Abstract

BACKGROUND

Different measures of antimicrobial are used to ensure proper usage, as part of structured antimicrobial stewardship programs.

OBJECTIVE

The main objective of this study is to describe the consumption of antibiotics in a mother-child teaching hospital using the AWaRe classification over a period of 15 years.

METHODS

This descriptive and retrospective study included all the data on antibiotic consumption of patients admitted to mother-child University Hospital from April 1st 2005 to March 31st, 2021. Of the 180 international non-proprietary names of antibiotics proposed by the World Health Organization (WHO), 54 were used. The number of days of treatment (DOT) per 1000 patient-days (PD) was calculated per year, per patientele (e.g. surgery, pediatrics, oncology, intensive care, neonatal intensive care, nursery, psychiatry, rehabilitation and obstetrics and gynecology) and globally. The data was classified per the WHO AWaRe classification.

RESULTS

A total of 10,489 DOT/1000PD were used globally in 15 years, corresponding to 53.9% of the "Access" group, 45.2% of the "Watch" group and 0.9% of the "Reserve" group. A reduction in the use of antibiotics was noted. The ratios of antibiotic consumptions in DOT/1000PD of 2020-2021 to 2005-2006 were 0.84 globally (1713/5653), 0.79 for the "Access" group (286/361), 0.89 for the "Watch" group (270/302) and 0.88 for the "Reserve" group (2.1/2.4).

CONCLUSION

The AWaRe classification was used to describe the consumption of antibiotics in a mother-child center. Our consumption compared favorably with international data and is in line with the WHO targets. This position may be linked to the presence of a structured anti-biogovernance program that has been in place for several years within our hospital. More work is needed to more precisely identify the antibiotics that should benefit from better supervision.

摘要

背景

作为结构化抗菌药物管理计划的一部分,采用了不同的抗菌药物衡量指标以确保合理使用。

目的

本研究的主要目的是使用AWaRe分类法描述一家母婴教学医院15年间的抗生素使用情况。

方法

这项描述性回顾性研究纳入了2005年4月1日至2021年3月31日期间入住母婴大学医院患者的所有抗生素使用数据。世界卫生组织(WHO)提出的180种国际非专利名称的抗生素中,有54种被使用。每年计算每1000患者日(PD)的治疗天数(DOT),按患者群体(如外科、儿科、肿瘤学、重症监护、新生儿重症监护、新生儿护理、精神病学、康复以及妇产科)和总体进行计算。数据按照WHO的AWaRe分类法进行分类。

结果

15年间总体共使用了10489 DOT/1000PD,其中“可及”组占53.9%,“谨慎使用”组占45.2%,“储备”组占0.9%。抗生素使用量有所下降。2020 - 2021年与2005 - 2006年的DOT/1000PD抗生素使用比例总体为0.84(1713/5653),“可及”组为0.79(286/361),“谨慎使用”组为0.89(270/302),“储备”组为0.88(2.1/2.4)。

结论

AWaRe分类法用于描述一家母婴中心的抗生素使用情况。我们的使用情况与国际数据相比具有优势,并且符合WHO的目标。这一情况可能与我院多年来实施的结构化抗菌管理计划有关。需要开展更多工作以更精确地确定应受益于更好监管的抗生素。

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