Department of Infection Management Office, Nanjing First Hospital，Nanjing Medical University, No. 68 of Changle Road, Qinhuai District, Nanjing 210006, China.
Department of Medical Service, Nanjing First Hospital，Nanjing Medical University, No. 68 of Changle Road, Qinhuai District, Nanjing 210006, China.
Int J Qual Health Care. 2023 Jun 6;35(2). doi: 10.1093/intqhc/mzad018.
Increased bacterial drug resistance has become a serious global public health problem. The application of antibiotics involves various clinical departments, and the rational application of antibiotics is the key to improving their efficacy. To provide a basis for further improving the etiological submission rate and standardizing the rational use of antibiotics, this article discusses the intervention effect of multi-department cooperation in improving the etiological submission rate before antibiotic treatment. A total of 87 607 patients were divided into a control group (n = 45 890) and an intervention group (n = 41 717) according to whether multi-department cooperation management was implemented. The intervention group involved the patients hospitalized from August to December 2021, while the control group involved the patients hospitalized from August to December 2020. The submission rates of the two groups; the rates before antibiotic treatment at the unrestricted use level, the restricted use level, and the special use level in departments; and the timing of submission were compared and analysed. The overall differences in the etiological submission rates before antibiotic treatment at the unrestricted use level (20.70% vs 55.98%), the restricted use level (38.23% vs 66.58%), and the special use level (84.92% vs 93.14%) were statistically significant before and after intervention (P < .05). At a more specific level, the etiological submission rates of different departments before antibiotic treatment at the unrestricted use level, the restricted use level, and the special use level were improved, but the special activities of multi-department cooperation management did not improve the submission timing significantly. Multi-department cooperation can effectively improve the etiological submission rates before antimicrobial treatment, but it is necessary to improve measures for specific departments to improve long-term management and incentive and restraint mechanisms.
细菌耐药性增加已成为严重的全球公共卫生问题。抗生素的应用涉及多个临床科室，合理应用抗生素是提高其疗效的关键。为进一步提高病原学送检率，规范抗生素的合理应用，本文探讨了多部门合作干预对提高抗生素治疗前病原学送检率的效果。将 87607 例患者根据是否实施多部门合作管理分为对照组（n=45890）和干预组（n=41717）。干预组纳入 2021 年 8 月至 12 月住院患者，对照组纳入 2020 年 8 月至 12 月住院患者。比较和分析两组的送检率；各科室不限用、限制使用和特殊使用级抗生素治疗前的送检率；以及送检时间。干预前后抗生素治疗前不限用级（20.70%比 55.98%）、限制使用级（38.23%比 66.58%）和特殊使用级（84.92%比 93.14%）的病原学送检率总体差异有统计学意义（P<0.05）。在更具体的水平上，不同科室抗生素治疗前不限用级、限制使用级和特殊使用级的病原学送检率均有所提高，但多部门合作管理的特殊活动对送检时间的改善不明显。多部门合作可以有效提高抗菌药物治疗前的病原学送检率，但需要改进针对具体科室的措施，以改善长期管理和激励约束机制。
