Xu Jinhui, Huang Jian, Yu YanXia, Zhou Dayong, Wang Ying, Xue Sudong, Shang Erning, Sun Jiantong, Ding Xinyuan, Shi Lu, Duan Lufen, Tang Lian, Zhou Qin, Li Xin
Department of Pharmacy, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Department of Vascular and Interventional Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Front Pharmacol. 2022 Feb 28;13:832078. doi: 10.3389/fphar.2022.832078. eCollection 2022.
The objective of the study was to assess the impact of multifaceted clinical pharmacist-led antimicrobial stewardship (AMS) program on the rational use of antibiotics for patients who receive vascular and interventional radiology therapies. A quasi-experimental retrospective intervention design with a comparison group was applied to the practice of antibiotic use in the department of vascular and interventional radiology in a Chinese tertiary hospital. We used difference-in-differences (DID) analysis to compare outcomes before and after the AMS intervention between the intervention group and control group, to determine whether intervention would lead to changes in irrationality of antibiotic prescribing, antibiotic utilization, cost of antibiotics, and length of hospital stay. The DID results showed that the intervention group was associated with a reduction in the average consumption of antibiotics ( = 0.017) and cost of antibiotics ( = 0.006) and cost per defined daily dose (DDD) ( = 0.000). There were no significant differences in the mean change of total costs and length of stay between the two groups ( > 0.05). The average inappropriate score of perioperative antimicrobial prophylaxis in the intervention group declined by 0.23, while it decreased by 0.02 in the control group [0.21 (95% CI, -0.271 to -0.143); = 0.000]. The average inappropriate score of non-surgical antimicrobial prophylaxis in the intervention group declined by 0.14, while it increased by 0.02 in the control group [0.16 (95% CI, -0.288 to -0.035); = 0.010]. The average inappropriate score of the therapeutic use of antibiotics in the intervention group declined by 0.07, while it decreased by 0.01 in the control group [0.06 (95% CI, -0.115 to -0.022); = 0.003]. This study provides evidence that implementation of AMS interventions was associated with a marked reduction of antibiotic use, cost of antibiotics, and irrationality of antibiotic prescribing in China.
本研究的目的是评估由临床药师主导的多方面抗菌药物管理（AMS）计划对接受血管和介入放射治疗患者合理使用抗生素的影响。在中国一家三级医院的血管和介入放射科，采用了带有对照组的准实验性回顾性干预设计来研究抗生素使用情况。我们使用差异-in-差异（DID）分析来比较干预组和对照组在AMS干预前后的结果，以确定干预是否会导致抗生素处方不合理性、抗生素使用、抗生素成本和住院时间的变化。DID结果显示，干预组的抗生素平均消耗量（=0.017）、抗生素成本（=0.006）和每限定日剂量（DDD）成本（=0.000）有所降低。两组之间的总成本和住院时间的平均变化没有显著差异（>0.05）。干预组围手术期抗菌药物预防的平均不当评分下降了0.23分，而对照组下降了0.02分[0.21（95%CI，-0.271至-0.143）；=0.000]。干预组非手术抗菌药物预防的平均不当评分下降了0.14分，而对照组上升了0.02分[0.16（95%CI，-0.288至-0.035）；=0.010]。干预组抗生素治疗使用的平均不当评分下降了0.07分，而对照组下降了0.01分[0.06（95%CI，-0.115至-0.022）；=0.003]。本研究提供了证据，表明在中国实施AMS干预与抗生素使用、抗生素成本和抗生素处方不合理性的显著降低有关。
Zotero 插件