Tunis Med. 2022;100(5):403-409.
Association between antibiotic use and antimicrobial resistance has been demonstrated in several studies; hence the importance of antibiotic stewardship programs (ASPs) to reduce the burden of this resistance.
To describe the antibiotic stewardship team (AST) interventions in a Tunisian university hospital.
a cross-sectional study was conducted in the infectious diseases department in Sousse-Tunisia between 2016 and 2020. Hospital and private practice doctors have been informed of the existence of an antibiotic stewardship team. Interventions consisted of some helps to antibiotic therapy (i.e.; prescription, change or discontinuation) and/or diagnosis (i.e.; further investigations).
Two thousand five hundred and fourteen interventions were made including 2288 (91%) in hospitalized patients, 2152 (86%) in university hospitals and 1684 (67%) in medical wards. The most common intervention consisted of help to antibiotic therapy (80%). The main sites of infections were skin and soft tissues (28%) and urinary tract (14%). Infections were microbiologically documented in 36% of cases. The most frequently isolated microorganisms were Enterobactriaceae (41%). Antibiotic use restriction was made in 44% of cases including further investigations (16%), antibiotic de-escalation (11%), no antibiotic prescription (9%) and antibiotic discontinuation (8%). In cases where antibiotics have been changed (N=475), the intervention was associated with an overall decrease in the prescription of broad-spectrum antibiotics from 61% to 50% with a decrease in the prescription of third generation cephalosporins from 22% to 15%.
The majority of antibiotic stewardship team's interventions were made in hospitalized patients, university hospitals and medical wards. These interventions resulted in an overall and broad-spectrum antibiotic use reduction.
多项研究表明，抗生素的使用与抗菌药物耐药性之间存在关联；因此，抗生素管理计划（ASPs）对于减轻这种耐药性负担非常重要。
描述突尼斯一家大学医院的抗生素管理团队（AST）的干预措施。
2016 年至 2020 年期间，在突尼斯苏塞的传染病科进行了一项横断面研究。医院和私人诊所的医生已经了解到抗生素管理团队的存在。干预措施包括对抗生素治疗（如处方、更改或停止）和/或诊断（如进一步检查）提供一些帮助。
共进行了 2514 次干预，其中 2288 次（91%）发生在住院患者中，2152 次（86%）发生在大学医院，1684 次（67%）发生在内科病房。最常见的干预措施是提供抗生素治疗方面的帮助（80%）。感染的主要部位是皮肤和软组织（28%）和尿路（14%）。在 36%的情况下，感染得到了微生物学证实。最常分离的微生物是肠杆菌科（41%）。在 44%的情况下限制了抗生素的使用，包括进一步检查（16%）、抗生素降级（11%）、无抗生素处方（9%）和抗生素停药（8%）。在抗生素发生改变的情况下（N=475），干预与广谱抗生素的处方总体减少相关，从 61%降至 50%，第三代头孢菌素的处方从 22%降至 15%。
抗生素管理团队的大多数干预措施是在住院患者、大学医院和内科病房中进行的。这些干预措施导致了广谱抗生素使用的总体减少。
