Cheng Jie, Dang ChuanDong, Li Xiao, Wang JianJun, Huang Xin, Li Yan, Cui XueYan
Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China.
Department of Clinical Pharmacy, The First Affiliated Hospital of Baotou Medical College, Baotou, China.
Front Pharmacol. 2023 Sep 7;14:1226333. doi: 10.3389/fphar.2023.1226333. eCollection 2023.
Central nervous system infection (CNSI) treatment in hospital neurosurgery emphasizes the importance of optimizing antimicrobial therapy. Timely and appropriate empiric antibiotic treatment is critical for managing patients with bacterial meningitis. To evaluate the activities of clinical pharmacists in the anti-infective treatment of patients with CNSI in neurosurgery. A single-center retrospective cohort study was carried out from January 2021 to March 2023 at a tertiary teaching hospital in China. The study sample included a group that received pharmacy services and a group that did not. In the pharmacy services group, the anti-infective treatment plan was led and developed by pharmacists. Pharmaceutical care, including medication therapy and all CNSI treatment regimens, was administered in daily unit rounds by pharmacists. Baseline demographics, treatment outcomes, and rational use of antibiotics were compared between the two groups, and the impact of a antimicrobial stewardship (AMS) program was evaluated. Of the 306 patients assessed according to the inclusion and exclusion criteria, 151 patients were included, and 155 patients were excluded due to abnormal data and missing information on antibiotic costs or antimicrobial use. Eventually, 73 were included in the pharmacy services group and 78 in the group without pharmacist participation. The antibiotic use density (AUD) of the pharmacy services group decreased from 167.68 to 127.63 compared to the group without pharmacist participation. After the pharmacist services, the AUD for linezolid decreased from 9.15% to 5.23% and that for miscellaneous agents decreased from 17.91% to 6.72%. The pharmacy services group had better improvement () and a significantly higher score for the rational use of antibiotics () than the group without pharmacist participation. The clinical pharmacist services evaluation results demonstrated an essential role of clinical pharmacist-led AMS programs in the effective and appropriate use of anti-infective treatments in neurosurgery with patients with CNSI.
医院神经外科的中枢神经系统感染（CNSI）治疗强调优化抗菌治疗的重要性。及时且恰当的经验性抗生素治疗对于细菌性脑膜炎患者的管理至关重要。为评估临床药师在神经外科CNSI患者抗感染治疗中的作用。于2021年1月至2023年3月在中国一家三级教学医院开展了一项单中心回顾性队列研究。研究样本包括接受药学服务的组和未接受药学服务的组。在药学服务组中，抗感染治疗方案由药师主导制定。药学监护，包括药物治疗和所有CNSI治疗方案，由药师在每日病房查房时实施。比较两组的基线人口统计学特征、治疗结果和抗生素合理使用情况，并评估抗菌药物管理（AMS）计划的影响。根据纳入和排除标准评估的306例患者中，151例患者被纳入，155例患者因数据异常以及抗生素费用或抗菌药物使用信息缺失而被排除。最终，73例患者被纳入药学服务组，78例患者被纳入无药师参与组。与无药师参与组相比，药学服务组的抗生素使用密度（AUD）从167.68降至127.63。药师服务后，利奈唑胺的AUD从9.15%降至5.23%，其他类药物的AUD从17.91%降至6.72%。药学服务组在（此处原文缺失具体内容）方面改善更好，且抗生素合理使用得分（此处原文缺失具体内容）显著高于无药师参与组。临床药师服务评估结果表明，临床药师主导的AMS计划在神经外科CNSI患者抗感染治疗的有效且恰当使用中发挥着重要作用。
