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开处方展望绿色未来:儿科医院和实践中抗菌药物废物管理以促进医疗保健可持续性的综述。

Prescribing a Green Future: A Review of Antimicrobial Waste in Pediatric Hospitals and Practices to Promote Healthcare Sustainability.

机构信息

Department of Pediatrics, Division of Pediatric Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.

Institute for Informatics, Data Sciences, and Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.

出版信息

J Pediatric Infect Dis Soc. 2024 Nov 27;13(11):561-567. doi: 10.1093/jpids/piae074.

Abstract

Pediatric hospitals are uniquely positioned to be impacted by antimicrobial waste. To explore this issue, we reviewed the current literature to identify the reasons, costs, and potential solutions to waste. Identified reasons for waste included weight-based dosing, medication order changes due to changing patient status, loss or expiration of doses, and medication errors. The cost of waste included financial costs, promotion of antimicrobial resistance, and generation of greenhouse gases. Proposed interventions to reduce waste included an early switch from intravenous to oral administration, required stop dates, standardized dosing times, and optimization of the pharmacy batching process. However, additional studies are needed to assess the potential correlation between these proposed interventions and waste reduction. Antimicrobial stewardship programs have been identified as a group that can play a crucial role in partnering to implement these interventions to potentially reduce antimicrobial waste and promote better healthcare sustainability.

摘要

儿科医院在受到抗菌药物废物影响方面具有独特的地位。为了探讨这个问题,我们查阅了现有文献,以确定造成浪费的原因、成本和潜在解决方案。浪费的原因包括基于体重的剂量、因患者病情变化而改变的药物医嘱、剂量的丢失或过期以及用药错误。浪费的成本包括财务成本、促进抗菌药物耐药性的产生以及温室气体的排放。减少浪费的干预措施包括尽早从静脉给药转为口服给药、设定停药日期、标准化给药时间以及优化药剂科配药过程。然而,还需要更多的研究来评估这些拟议干预措施与减少浪费之间的潜在相关性。抗菌药物管理计划已被确定为一个可以发挥关键作用的团体,通过合作实施这些干预措施,有可能减少抗菌药物废物的产生,促进更好的医疗保健可持续性。

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