Zirpe Kapil Gangadhar, Kapse Upendrakumar S, Gurav Sushma Kirtikumar, Tiwari Anand Mohanlal, Deshmukh Abhijit Manikrao, Suryawanshi Prasad Bhimrao, Bhoyar Abhaya Pramodrao, Wankhede Prajkta Prakash, Desai Devashish, Suryawanshi Rupali, John Rebecca, Bhagat Soniya
Department of Neurotrauma Unit, Grant Medical Foundation's Ruby Hall Clinic, Pune, Maharashtra, India.
Department of Infectious Diseases Specialist, Grant Medical Foundation's Ruby Hall Clinic, Pune, Maharashtra, India.
Indian J Crit Care Med. 2023 Oct;27(10):737-742. doi: 10.5005/jp-journals-10071-24543.
Antibiotics are the most commonly exploited agents in intensive care units. An antimicrobial stewardship program (ASP) helps in the optimal utilization of antibiotics and prevents the development of antibiotic resistance. The aim of this study was to assess the impact of ASP on broad-spectrum antibiotic consumption in terms of defined daily dose (DDD) and days of therapy (DOT) before and after the implementation of an ASP.
It was a prospective, quasi-experimental, pre- and post-study. Group A consisted of 5 months of ASP data, ASP activities were implemented during the next 2 months and continued. Group B (post-ASP) data was collected for the next 5 months. Total and individual DDDs and DOTs of broad-spectrum antibiotics utilized were compared between group A and group B.
Total DDDs used per 100 patient bed days were reduced by 18.72% post-ASP implementation (103.46 to 84.09 grams). The total DOT per 100 patient bed days used was 90.91 vs 71.25 days (21.62% reduction). As per the WHO classification of antibiotics use, the watch category (43.4% vs 43.04%) as well as reserve category (56.6% vs 56.97%) used between the two groups were found similar. The average length of stay (8.9 ± 2 days) after ASP was found significantly lesser than baseline (10.8 ± 3.4 days) ( < 0.05), however, there was no significant change in mortality between the two groups.
Antimicrobial stewardship program implementation may reduce overall antibiotic consumption both in terms of DDD and DOT.
Zirpe KG, Kapse US, Gurav SK, Tiwari AM, Deshmukh AM, Suryawanshi PB, . Impact of an Antimicrobial Stewardship Program on Broad Spectrum Antibiotics Consumption in the Intensive Care Setting. Indian J Crit Care Med 2023;27(10):737-742.
抗生素是重症监护病房中最常用的药物。抗菌药物管理计划(ASP)有助于优化抗生素的使用,并防止抗生素耐药性的产生。本研究的目的是评估ASP在实施前后对广谱抗生素使用量的影响,以限定日剂量(DDD)和治疗天数(DOT)来衡量。
这是一项前瞻性、准实验性的前后对照研究。A组包含5个月的ASP数据,在接下来的2个月实施并持续开展ASP活动。B组(ASP实施后)收集接下来5个月的数据。比较A组和B组中使用的广谱抗生素的总DDD和个体DDD以及DOT。
ASP实施后,每10个患者床日使用的总DDD减少了18.72%(从103.46克降至84.09克)。每100个患者床日使用的总DOT为90.91天对71.25天(减少了21.62%)。根据世界卫生组织的抗生素使用分类,发现两组之间使用的观察类(43.4%对43.04%)以及储备类(56.6%对56.97%)相似。发现ASP实施后的平均住院时间(8.9±2天)显著短于基线(10.8±3.4天)(P<0.05),然而,两组之间的死亡率没有显著变化。
实施抗菌药物管理计划可能会在DDD和DOT方面减少总体抗生素使用量。
Zirpe KG, Kapse US, Gurav SK, Tiwari AM, Deshmukh AM, Suryawanshi PB, 。抗菌药物管理计划对重症监护环境中广谱抗生素使用的影响。《印度重症监护医学杂志》2023;27(10):737 - 742。