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意大利南部一家医院的新冠疫情前后抗生素使用情况及管理计划

Pre- and Post-COVID-19 Antibiotic Consumption and Stewardship Program in a Southern Italian Hospital.

作者信息

Costantino Maria, Giudice Valentina, Campana Federica, Iannelli Alessandra Anna, Scala Pasqualina, Longanella Walter, Marongiu Francesco, Vozzella Emilia Anna, Elberti Maria Giovanna, Alfieri Maria, Boccia Giovanni, Conti Valeria, De Caro Francesco, Filippelli Amelia

机构信息

Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy.

University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84121 Salerno, Italy.

出版信息

Antibiotics (Basel). 2024 Nov 24;13(12):1128. doi: 10.3390/antibiotics13121128.

Abstract

BACKGROUND/OBJECTIVES: Antibiotic resistance is a growing global threat that significantly impacts public health and healthcare costs. The Italian National Action Plan on Antimicrobial Resistance (PNCAR) was introduced in 2017 to address this issue by improving antibiotic stewardship. This study aimed to evaluate the effectiveness of the PNCAR in enhancing antibiotic management practices in a hospital in southern Italy before and after its implementation.

METHODS

We conducted an observational monocentric study to analyze antibiotic consumption in a hospital setting before and after the COVID-19 pandemic (2019 and 2023) and to examine prescription appropriateness and the types of used antibiotics.

RESULTS

After PNCAR introduction, we recorded a significant increase in antibiotic prescription appropriateness and in Access antibiotic and targeted therapy usage, while Reserve antibiotics were prescribed in ~10% of the cases, with an increasing trend in 2023.

CONCLUSIONS

Our study supports the importance of targeted stewardship initiatives, including continuous monitoring and education, to sustain antibiotic prescription appropriateness and to reduce antimicrobial resistance.

摘要

背景/目的:抗生素耐药性是一个日益严重的全球威胁,对公众健康和医疗成本产生重大影响。意大利国家抗菌药物耐药性行动计划(PNCAR)于2017年推出,旨在通过改善抗生素管理来解决这一问题。本研究旨在评估PNCAR在意大利南部一家医院实施前后增强抗生素管理实践的有效性。

方法

我们进行了一项单中心观察性研究,以分析2019年和2023年新冠疫情前后医院环境中的抗生素消费情况,并检查处方的合理性以及所用抗生素的类型。

结果

引入PNCAR后,我们记录到抗生素处方合理性以及可及性抗生素和靶向治疗的使用显著增加,而储备抗生素的处方率约为10%,2023年呈上升趋势。

结论

我们的研究支持有针对性的管理举措的重要性,包括持续监测和教育,以维持抗生素处方的合理性并减少抗菌药物耐药性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bd3/11672782/f5b947d378e4/antibiotics-13-01128-g001.jpg

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