使用国家审计工具评估英国一家急性医院抗生素处方的适宜性：一项单中心回顾性调查。

Assessment of the appropriateness of antibiotic prescribing in an acute UK hospital using a national audit tool: a single centre retrospective survey.

机构信息

Emergency Department, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK

Medical Microbiology, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK.

出版信息

Eur J Hosp Pharm. 2024 Oct 25;31(6):505-510. doi: 10.1136/ejhpharm-2022-003569.

DOI:10.1136/ejhpharm-2022-003569

PMID:37117009

Abstract

INTRODUCTION

Antibiotic use drives antibiotic resistance. The UK antimicrobial resistance (AMR) strategy aims to reduce antibiotic use. We aimed to quantify excess antibiotic use in a district general hospital in south-west England.

METHODS

Medical patients discharged in August 2020 who had received antibiotics were included. An audit tool of antibiotic prescribing appropriateness was used to collect relevant clinical information regarding each patient case. The appropriateness of antibiotic use was then determined by two infection specialists and excess days of therapy (DOTs) calculated.

RESULTS

647 patients were discharged in August 2020. Of the 1658 antibiotic DOTs for the 184 patients reviewed, 403 (24%) were excess DOTs. The excess antibiotic DOTs were prescribed in 92 patients (50%); 112/403 (27.8%) excess DOTs originated at the initiation of antibiotic therapy (time point A); 184/403 (45.7%) of excess DOTs occurred at the antibiotic review pre-72 hours (time point B); and 107/403 (26.6%) of excess DOTs were due to protracted antibiotic courses (time point C).

CONCLUSION

24% of antibiotic DOTs were deemed unnecessary. The greatest opportunity to reduce antibiotic use safely was the pre-72 hours antibiotic review, which may provide a target for reducing excess antimicrobial therapy in line with the national AMR strategy.

摘要

简介

抗生素的使用导致了抗生素耐药性。英国抗菌药物耐药性（AMR）战略旨在减少抗生素的使用。我们旨在量化英格兰西南部一家地区综合医院的过度抗生素使用情况。

方法

纳入 2020 年 8 月出院且接受过抗生素治疗的住院患者。使用抗生素处方适宜性审核工具收集每位患者的相关临床信息。然后由两名感染专家确定抗生素使用的适宜性，并计算出多余的治疗天数（DOTs）。

结果

2020 年 8 月有 647 名患者出院。在对 184 名患者的 1658 个抗生素 DOTs 进行审查中，有 403 个（24%）是多余的 DOTs。92 名患者（50%）开出了多余的抗生素 DOTs；在抗生素治疗开始时（时间点 A）开出了 112/403 个（27.8%）多余的 DOTs；在抗生素治疗前 72 小时的抗生素审查时（时间点 B）开出了 184/403 个（45.7%）多余的 DOTs；在延长抗生素疗程时（时间点 C）开出了 107/403 个（26.6%）多余的 DOTs。