Qian Can, Yuan Ting, Zhang Fuyong, Gou Shiyuan, Jiang Chunmei, Chen Xuebing, Huang Ya, Zhao Xiaolin, Du You, Li Chenglong, Han Yangyun, Su Huaiyu
Department of Pharmacy, Deyang People's Hospital, Deyang, China.
Department of Medical Affairs, Deyang People's Hospital, Deyang, China.
Front Med (Lausanne). 2025 Jun 25;12:1583134. doi: 10.3389/fmed.2025.1583134. eCollection 2025.
Antimicrobial Stewardship programs are crucial for reducing overall antibiotic consumption, but in practice, there are often issues with unclear responsibilities and ambiguous tasks. Pharmacists play a critical role in AMS due to their combined management functions and professional expertise.
To investigate the impact of a Pharmacist-Driven Antimicrobial Stewardship program on the consumption of antibiotics in a hospital.
Under the support of a hospital top-level design, we implemented a Pharmacist-Driven Antimicrobial Stewardship program led by pharmacists and involving multiple disciplines. The program focused on revising the antibiotic formulary and optimizing key points of antibiotic management, using the inpatient Antibiotic Use Density as the core control indicator. This was conducted through three phases: program initiation, implementation, monitoring and control. Clinical pharmacists ensured the long-term operational quality of the program. We evaluated the impact of the program on relevant indicators of antimicrobial consumption in inpatient.
Compared to the pre-implementation year of 2020, the annual Antibiotic Use Density for inpatients across the hospital decreased by 22.28% in 2024, reaching 36.26 defined daily doses/100 patient days. Additionally, the monthly inpatient Antibiotic Use Density in 2024 was significantly reduced ( < 0.001), along with the antibiotic usage rate ( < 0.05), expenditure on antibiotics per inpatient ( < 0.001), and the proportion of antibiotic expenditure relative to total for inpatients ( < 0.001). The rational use of antimicrobial agents in inpatient wards has been enhanced. Through targeted management, some antibiotics showed trends of increased or decreased usage. The detection rates of Methicillin-Resistant and Extended-spectrum β-lactamase-producing did not show a significant decrease.
The Pharmacist-Driven Antimicrobial Stewardship program effectively leveraged the managerial roles and professional skills of pharmacists in rational drug use management, resulting in a significant reduction in hospital antibiotic consumption. However, to further validate its effectiveness in reversing bacterial resistance, the program requires longer-term operation and could be considered for regional expansion.
抗菌药物管理计划对于减少总体抗生素使用量至关重要，但在实践中，往往存在职责不清和任务不明确的问题。药剂师因其综合管理职能和专业知识，在抗菌药物管理中发挥着关键作用。
调查药剂师主导的抗菌药物管理计划对某医院抗生素使用的影响。
在医院顶层设计的支持下，我们实施了一项由药剂师主导、多学科参与的抗菌药物管理计划。该计划以修订抗生素处方集和优化抗生素管理要点为重点，将住院患者抗生素使用密度作为核心控制指标。通过计划启动、实施、监测与控制三个阶段进行。临床药师确保了该计划的长期运行质量。我们评估了该计划对住院患者抗菌药物使用相关指标的影响。
与2020年实施前一年相比，2024年全院住院患者的年度抗生素使用密度下降了22.28%，降至36.26限定日剂量/100患者日。此外，2024年每月住院患者的抗生素使用密度显著降低（<0.001），同时抗生素使用率（<0.05）、每位住院患者的抗生素支出（<0.001）以及抗生素支出占住院患者总支出的比例（<0.001）均显著降低。住院病房抗菌药物的合理使用得到了加强。通过针对性管理，部分抗生素呈现出使用量增加或减少的趋势。耐甲氧西林金黄色葡萄球菌和产超广谱β-内酰胺酶菌的检出率未出现显著下降。
药剂师主导的抗菌药物管理计划有效发挥了药剂师在合理用药管理中的管理作用和专业技能，使医院抗生素使用量显著降低。然而，为进一步验证其在逆转细菌耐药性方面的有效性，该计划需要更长时间的运行，并可考虑进行区域推广。
