Blok W L, Gyssens I C, Hekster Y A, Koopmans P P, van der Meer J W
Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands.
Pharm World Sci. 1996 Aug;18(4):137-41. doi: 10.1007/BF00717729.
Inadequate control of antimicrobial drug use may lead to excessive expenditure for antimicrobial drugs and improper prescribing it may also result in the emergence of multiresistant bacteria. An antibiotic order form may improve the quality of prescriptions by increasing the awareness of the physician of the antimicrobial spectrum needed (i.e. which microorganism is expected in a given patient), the desired duration of treatment, the potential need to adjust dosage, and the potential allergy of the patient to the drug. Furthermore, such an antibiotic order form facilitates prospective evaluation of both the quantity and the quality of prescribing practice. However, the introduction of yet another form to fill in may be met with opposition from prescribers. We have developed an easy-to-use antibiotic order form that incorporated the conventional medication order that was already in use in our hospital. Compliance (percentage of antimicrobial drug prescriptions for which an order form was used) was on average 58% in the first two weeks after introduction, and remained thereafter between 60% and 90%, varying between the different wards. Data retrieved from the antibiotic order forms could be used for surveillance We conclude that this antibiotic order form was feasible in a large department of internal medicine of a university hospital. Future usefulness will depend on compliance and on personnel support for data processing and intervention.
抗菌药物使用控制不当可能导致抗菌药物支出过高,而处方不当还可能导致多重耐药菌的出现。抗生素医嘱单可通过提高医生对抗菌谱(即特定患者可能感染的微生物)、所需治疗时长、调整剂量的潜在需求以及患者对药物潜在过敏反应的认识,从而提高处方质量。此外,这种抗生素医嘱单有助于对处方行为的数量和质量进行前瞻性评估。然而,引入另一张需要填写的表单可能会遭到开处方者的反对。我们开发了一种易于使用的抗生素医嘱单,它整合了我院已在使用的传统用药医嘱。在引入后的前两周,合规率(使用医嘱单的抗菌药物处方百分比)平均为58%,此后在不同病房之间有所差异,保持在60%至90%之间。从抗生素医嘱单中检索到的数据可用于监测。我们得出结论,这种抗生素医嘱单在大学医院的大型内科可行。其未来的实用性将取决于合规情况以及对数据处理和干预的人员支持。