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巴西一家三级医院重症监护病房抗菌药物的使用情况及成本特征分析

Characterization of consumption and costs of antimicrobials in intensive care units in a Brazilian tertiary hospital.

作者信息

de Castro Tázia Lopes, Cambiais Amanda Magalhães Vilas Boas, Sforsin Andrea Cassia Pereira, Pinto Vanusa Barbosa, Falcão Maria Alice Pimentel

机构信息

Pharmacy Division, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (HC-FMUSP), São Paulo, SP, Brazil.

Uniprofessional Residency Program in Hospital and Clinical Pharmaceutical Assistance, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), São Paulo, SP, Brazil.

出版信息

Explor Res Clin Soc Pharm. 2023 Jun 12;11:100289. doi: 10.1016/j.rcsop.2023.100289. eCollection 2023 Sep.

Abstract

BACKGROUND

The consumption of antimicrobials and the growing resistance of infectious agents to these drugs are not related only to health issues, but also to economic parameters.

OBJECTIVES

The study objective was to evaluate the consumption of antimicrobials in General and Covid-19 Intensive Care Units (ICUs) and the impact on institutional costs in the largest institute of a tertiary public hospital.

METHODS

This is a quantitative and retrospective study, which analyzed consumption, through the Defined Daily Dose (DDD), and the annual direct cost of antimicrobials in Reais (R$) and Dollars (US$), from January to December 2021.

RESULTS

The total annual consumption (DDD/1000 patient-day) of antimicrobials in the ICUs was 14,368.85. β-Lactams had the highest total annual value, with a DDD/1000 patient-day of 7062.98, being meropenem the antimicrobial that reached the highest consumption (3107.20), followed by vancomycin (2322.6). Total consumption was higher in Covid-19 ICUs than in General ICUs, and the annual direct cost of antimicrobials in ICUs was US$560,680.79.

CONCLUSIONS

The study showed high consumption of broad-spectrum antimicrobials, highlighting the importance of structuring programs to manage the use of antimicrobials, both to reduce antimicrobial consumption and hospital costs, consolidating rational use even in pandemic scenarios.

摘要

背景

抗菌药物的使用以及感染病原体对这些药物不断增强的耐药性不仅与健康问题相关,还与经济参数有关。

目的

本研究旨在评估一所大型三级公立医院的综合重症监护病房(ICU)和新冠重症监护病房中抗菌药物的使用情况及其对机构成本的影响。

方法

这是一项定量回顾性研究,通过限定日剂量(DDD)分析了2021年1月至12月抗菌药物的使用量以及以雷亚尔(R$)和美元(US$)计的抗菌药物年度直接成本。

结果

重症监护病房抗菌药物的年度总使用量(DDD/1000患者日)为14368.85。β-内酰胺类药物的年度总值最高,DDD/1000患者日为7062.98,其中美罗培南的使用量最高(3107.20),其次是万古霉素(2322.6)。新冠重症监护病房的总使用量高于综合重症监护病房,重症监护病房抗菌药物的年度直接成本为560680.79美元。

结论

该研究表明广谱抗菌药物的使用量较高,凸显了制定抗菌药物使用管理计划的重要性,这既能减少抗菌药物的使用量,又能降低医院成本,即使在疫情期间也能巩固合理用药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3627/10338357/714f93b4364d/gr1.jpg

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