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2011年至2021年中国临床药师在妇产科进行抗菌药物管理对抗菌指标、细菌耐药性及药物成本的影响

The impact of antimicrobial management by clinical pharmacists in obstetrics and gynecology on antimicrobial indicators, bacterial resistance and drug costs from 2011 to 2021 in China.

作者信息

Jin Jing, Zhu JiaLei, Tang Jing

机构信息

Department of Pharmacy, The Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Yangpu District, Shanghai 200090, China.

出版信息

Heliyon. 2023 Jun 12;9(6):e16851. doi: 10.1016/j.heliyon.2023.e16851. eCollection 2023 Jun.

DOI:10.1016/j.heliyon.2023.e16851
PMID:37389079
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10300213/
Abstract

OBJECTIVES

The goal of our study is to analyze the effectiveness and role of clinical pharmacists in antibiotic management through retrospective research from 2011 to 2021, depending on the current scenario of the antibiotic application in China.

METHODS

We formed a team of pharmacists to carry out multifaceted intervention measures, such as forming a working group, developing a plan, establishing management rules via the pre-trial system, prescription comments, collaborating with the administrative department, implementing training and publicity, and so on. Antibiotic use was studied, bacterial drug resistance was determined, and antibiotic costs were computed.

RESULTS

The pharmacist intervention and rectification of inappropriate antibacterial drug orders considerably enhanced the rational use rate of antibiotics and reduced the cost of antibiotics. Antibiotic use in clean surgery decreased from 90.22% to 11.14%, the use rate of antibiotics decreased from 63.82% to 30.26%, and antibiotic use intensity decreased from 42.75DDDs to 30.04DDDs. The types, timing, and course of antibacterials used in wards were all improved to varying degrees. Bacterial drug resistance improved noticeably, with resistance of to cephalosporins, ciprofloxacin and carbapenems decreased in varying degrees. The use of antibacterial drugs has decreased significantly.

CONCLUSIONS

It is feasible and effective for pharmacists in gynecology and obstetrics to control antibiotic use, which plays a positive role in promoting the safe, effective, and cost-effective use of antibiotics and serves as a valuable reference for the antibiotic management.

摘要

目的

根据中国抗生素应用的现状,通过对2011年至2021年的回顾性研究,分析临床药师在抗生素管理中的有效性和作用。

方法

我们组建了一个药师团队,采取多方面的干预措施,如成立工作组、制定计划、通过预审核制度建立管理规则、处方点评、与行政部门协作、开展培训与宣传等。研究抗生素使用情况,测定细菌耐药性,并计算抗生素费用。

结果

药师对抗菌药物医嘱的干预和纠正显著提高了抗生素的合理使用率,降低了抗生素费用。清洁手术中抗生素使用率从90.22%降至11.14%,抗生素使用比例从63.82%降至30.26%,抗生素使用强度从42.75DDDs降至30.04DDDs。病房抗菌药物使用的种类、时机和疗程均有不同程度改善。细菌耐药性明显改善,对头孢菌素、环丙沙星和碳青霉烯类的耐药性均有不同程度下降。抗菌药物使用显著减少。

结论

妇产科药师控制抗生素使用是可行且有效的,对促进抗生素的安全、有效和经济使用起到积极作用,为抗生素管理提供了有价值的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/e59956b477a2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/255a7780a52e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/e89a08cbc1ee/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/e59956b477a2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/255a7780a52e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/e89a08cbc1ee/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c345/10300213/e59956b477a2/gr3.jpg

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