特殊级抗菌药物科学化管理在重症监护病房中的应用
作者:
作者单位:

1.广州中医药大学第一附属医院 重症医学科, 广东 广州 510080;2.广州中医药大学第一附属医院 检验科, 广东 广州 510080

作者简介:

通讯作者:

林新锋  E-mail: lin-xf1@163.com

中图分类号:

R197.323

基金项目:


Application of antimicrobial stewardship program of special grade antimicrobial agents in intensive care unit
Author:
Affiliation:

1.Intensive Care Unit, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510080, China;2.Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510080, China

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的 评价抗菌药物科学化管理(ASP)在重症监护病房(ICU)中对碳青霉烯类抗生素的管理效果。 方法 回顾性分析2018年4月1日-2020年3月31日某院ICU住院患者的临床资料, 2019年4月1日开始实施ASP, 以碳青霉烯类抗生素使用频度(DDDs)和使用强度(AUD)作为ASP评价标准。 结果 ASP实施前后患者一般资料比较、感染患者和非感染患者的ICU住院日数及病死率比较, 差异均无统计学意义(均P>0.05)。ASP实施后, 碳青霉烯类抗生素DDDs从2 101.25下降至1 862.25, 差异无统计学意义(P>0.05);碳青霉烯类抗生素AUD从43.34 DDDs/100例·d下降至31.32 DDDs/100例·d, 差异有统计学意义(P < 0.05)。鲍曼不动杆菌、肺炎克雷伯菌对碳青霉烯类抗生素的耐药率分别从实施前的90.00%、20.41%下降至实施后的73.21%、10.14%, 差异具有统计学意义(均P < 0.05)。 结论 以ICU为中心实施ASP可降低碳青霉烯类抗生素DDDs和AUD, 降低细菌对碳青霉烯类抗生素的耐药率, 但不增加患者的ICU住院日数及病死率。

    Abstract:

    Objective To evaluate the effect of antimicrobial stewardship program (ASP) on carbapenem antibiotics in intensive care unit (ICU). Methods Clinical data of ICU patients in a hospital from April 1, 2018 to March 31, 2020 were retrospectively analyzed, ASP was implemented from April 1, 2019, the frequency of defined daily doses (DDDs) and antimicrobial use density (AUD) of carbapenem antibiotics were used as the evaluation criteria of ASP. Results Before and after implementation of ASP, there was no significant difference in general data of patients, length of ICU stay and mortality between infected and non-infected patients (all P>0.05). After the implementation of ASP, DDDs of carbapenem antibiotics decreased from 2 101.25 to 1 862.25, difference was not significant (P>0.05); AUD of carbapenem antibiotics decreased from 43.34 DDDs/100 cases·day to 31.32 DDDs/100 cases·day, difference was significant (P < 0.05). Resistance rates of Acinetobacter baumannii and Klebsiella pneumoniae to carbapenem antibiotics decreased from 90.00% and 20.41% before implementation to 73.21% and 10.14% after implementation respectively, difference was significant (both P < 0.05). Conclusion The implementation of ASP centered in ICU can reduce the DDDs and AUD of carbapenem antibiotics, reduce resistance rate of bacteria to carbapenem antibiotics, but does not increase length of ICU stay and mortality of patients.

    参考文献
    相似文献
引用本文

许建强,徐倩,赵锋利,等.特殊级抗菌药物科学化管理在重症监护病房中的应用[J]. 中国感染控制杂志,2022,(3):291-296. DOI:10.12138/j. issn.1671-9638.20222128.
Jian-qiang XU, Qian XU, Feng-li ZHAO, et al. Application of antimicrobial stewardship program of special grade antimicrobial agents in intensive care unit[J]. Chin J Infect Control, 2022,(3):291-296. DOI:10.12138/j. issn.1671-9638.20222128.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2021-11-11
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2024-04-28
  • 出版日期: