Bailey T C, Ritchie D J, McMullin S T, Kahn M, Reichley R M, Casabar E, Shannon W, Dunagan W C
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Pharmacotherapy. 1997 Mar-Apr;17(2):277-81.
To evaluate a program to discontinue intravenous antibiotics at two teaching hospitals, 102 inpatients meeting eligibility criteria were randomly assigned to two groups. In one group, patients' physicians were contacted by pharmacists with recommendations to discontinue intravenous antibiotic therapy; in the other, patients were simply observed. Measured outcomes were antibiotic costs, length of stay, need to restart intravenous antibiotics, in-hospital mortality, and 30-day readmissions. The intervention significantly reduced mean antibiotic costs per patient ($19.82 vs $35.84, p = 0.03), but related labor costs exceeded this benefit. Readmissions were significantly more frequent in the intervention group than in the control group (29% vs 9.8% p = 0.02), but they were not infection related. No impact was demonstrated on the other measured outcomes. Institutions considering such programs or with one in place should conduct similar evaluations.
为评估两家教学医院停用静脉注射抗生素的项目，102名符合资格标准的住院患者被随机分为两组。在一组中，药剂师联系患者的医生并给出停用静脉注射抗生素治疗的建议；在另一组中，仅对患者进行观察。测量的结果包括抗生素费用、住院时间、重新开始静脉注射抗生素的必要性、院内死亡率和30天再入院率。干预措施显著降低了每位患者的平均抗生素费用（19.82美元对35.84美元，p = 0.03），但相关劳动力成本超过了这一益处。干预组的再入院率显著高于对照组（29%对9.8%，p = 0.02），但这些再入院与感染无关。在其他测量结果方面未显示出影响。考虑实施此类项目或已实施该项目的机构应进行类似评估。
