Department of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Pharmacy, China-Japan Friendship Hospital, Beijing, People's Republic of China.
Medicine (Baltimore). 2021 Dec 30;100(52):e28458. doi: 10.1097/MD.0000000000028458.
This study aimed to assess the impact of the pharmacist-led intervention on perioperative antibiotic prophylaxis by standardizing the cephalosporin intradermal skin test in the orthopedic department.A pre-and postintervention study was conducted among patients in the Orthopedics Department at the Beijing Chao-Yang Hospital in China. Use of intradermal skin test, perioperative antibacterial prophylaxis, and cost of care were compared between the preintervention population (admitted from 6/1/2018 to 8/31/2018) and postintervention population (admitted from 1/1/2019 to 3/31/2019). Logistic regression and generalized linear regression were used to assess the intervention impact.425 patients from the preintervention period and 448 patients from the postintervention period were included in the study. After the implementation of the pharmacist intervention program, there was a decrease in the utilization of intradermal skin tests, from 95.8% to 16.5% (P < .001). Patients were more likely to have cephalosporin as prophylactic antimicrobials (OR = 5.28, P < .001) after the implementation. The cost of antimicrobials was significantly reduced by $150.21 (P < .001) for each patient.Pharmacist-involved intervention can reduce the utilization of cephalosporins skin tests and decrease the prescription of unnecessary high-cost antimicrobials.
本研究旨在评估药剂师主导的干预措施对围手术期抗生素预防的影响，方法是规范骨科中头孢菌素皮内皮肤试验。在中国北京朝阳医院骨科，进行了一项干预前后的研究。比较了干预前人群（2018 年 6 月 1 日至 8 月 31 日入院）和干预后人群（2019 年 1 月 1 日至 3 月 31 日入院）的皮内皮肤试验、围手术期抗菌预防和护理费用。采用逻辑回归和广义线性回归评估干预效果。本研究纳入了 425 例干预前患者和 448 例干预后患者。在实施药剂师干预方案后，皮内皮肤试验的使用率从 95.8%下降至 16.5%（P<0.001）。实施后，患者更有可能使用头孢菌素作为预防用抗生素（OR=5.28，P<0.001）。每位患者的抗生素费用降低了 150.21 美元（P<0.001）。药剂师参与的干预可以减少头孢菌素皮肤试验的使用，并减少不必要的高价抗生素的处方。
