Effect of Weekly Antibiotic Round on Antibiotic Use in the Neonatal Intensive Care Unit as Antibiotic Stewardship Strategy.
Effect of Weekly Antibiotic Round on Antibiotic Use in the Neonatal Intensive Care Unit as Antibiotic Stewardship Strategy.
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DOI：
10.3389/fped.2020.604244
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发表时间：
2020
影响因子：
2.6
通讯作者：
Hei M
中科院分区：
文献类型：
--
作者：
Wang B;Li G;Jin F;Weng J;Peng Y;Dong S;Liu J;Luo J;Wu H;Shen Y;Meng Y;Wang X;Hei M
背景：抗生素常用于新生儿重症监护病房（NICU）。目的是观察 NICU 每周抗生素轮次（WARN）对 NICU 抗生素使用的影响。方法：进行回顾性观察研究。收集2016-2017年（第一阶段）和2018-2019年（第二阶段）NICU科室诊断类别和抗生素使用参数。 NICU WARN自2018年1月开始。根据第一阶段的数据，采用时间序列预测来预测第二阶段的季度抗生素使用情况。将第二阶段每个季度的实际抗生素使用情况与预测值进行比较。结果：共纳入 9297 名新生儿（第一阶段 4743 名，第二阶段 4488 名）。第一阶段和第二阶段疾病谱的组成没有差异（P > 0.05）。第一阶段和第二阶段的总体抗生素使用率分别为94.4%和74.2%，每月平均累积定义日剂量分别为199.00±55.77和66.80±45.64，每月抗生素使用密度中位数分别为10.31（9.00-13.27）和2.48（1.92-4.66），中位累积定义剂量每月每例每日剂量为0.10（0.09-0.13）和0.03（0.02-0.47），每月每1000住院天接受任何一种抗生素的患者人数为103.45（99.30-107.48）和78.66（74.62-82.77），抗生素前培养检查率为64至分别为 92%，均优于预测值（P < 0.01）。结论：实施定期抗生素查房可有效减少 NICU 抗生素的使用。
Background: Antibiotics are commonly used in the neonatal intensive care unit (NICU). The objective was to observe the effect of weekly antibiotic round in NICU (WARN) to the antibiotic use in NICU. Methods: A retrospective observational study was performed. Departmental-level diagnosis categories and the parameters of antibiotic usage in NICU for the period of 2016-2017 (Phase 1) and 2018-2019 (Phase 2) were collected. WARN in NICU was started since January 2018. A time series forecasting was used to predict the quarterly antibiotic use in Phase 2, based on data from Phase 1. The actual antibiotic use of each quarter in Phase 2 was compared with the predicted values. Results: Totally 9297 neonates were included (4743 in Phase 1, 4488 in Phase 2). The composition of the disease spectrum between Phase 1 and Phase 2 was not different (P > 0.05). In Phase 1 and Phase 2, the overall antibiotic rate was 94.4 and 74.2%, the average accumulative defined daily dose per month was 199.00 ± 55.77 and 66.80 ± 45.64, the median antibiotic use density per month was 10.31 (9.00-13.27) and 2.48 (1.92-4.66), the median accumulative defined daily dose per case per month was 0.10 (0.09-0.13) and 0.03 (0.02-0.47), the number of patients who received any kind of antibiotic per 1000 hospital days per month was 103.45 (99.30-107.48) and 78.66 (74.62-82.77), rate of culture investigation before antibiotics was 64 to 92%, respectively, and all were better than the predicted values (P < 0.01). Conclusion: The implementation of periodical antibiotic rounds was effective in reducing the antibiotics use in the NICU.
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作者：
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通讯作者：
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