Surveillance of antimicrobial use and antimicrobial resistance in intensive care units (SARI): 1. Antimicrobial use in German intensive care units
Surveillance of antimicrobial use and antimicrobial resistance in intensive care units (SARI): 1. Antimicrobial use in German intensive care units
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重症监护病房抗菌药物使用和抗菌药物耐药性监测 (SARI)： 1. 德国重症监护病房抗菌药物使用情况
DOI：
10.1007/s00134-004-2266-9
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发表时间：
2004
影响因子：
38.9
通讯作者：
F. Daschner
中科院分区：
文献类型：
--
作者：
E. Meyer;F. Schwab;D. Jonas;H. Rueden;P. Gastmeier;F. Daschner
目的研究抗菌药物使用的基准和确保质量的抗菌药物治疗，并确定危险因素与高使用抗菌药物在德国重症监护病房（ICU）通过实施SARI（抗菌药物使用和抗菌药物耐药性监测在ICU）system.DesignProspective，单位为基础的抗菌药物使用的监测从2000年2月至2002年6月。通过使用定义的每日剂量（DDD）为每个抗菌定义的世界卫生组织和计算使用每1000 patient days.SettingThe数据是从35个德国ICU和ICU（医疗，外科，跨学科）的类型分层的使用标准化的数据。ResultsTo日期，该项目涵盖了744个报告的ICU月和354,356 DDDs共266,013患者天。平均抗菌药物使用密度（AD）为1，332 DDD/1000患者日，与住院时间相关。青霉素类和β-内酰胺酶抑制剂（AD 338.3）和喹诺酮类（155.5）是AD最高的抗菌药物组。与美国ICARE（重症监护抗菌药物耐药性流行病学）/AUR（抗菌药物使用和耐药性）数据的比较显示，ICARE/AUR ICU中糖肽类和第三代头孢菌素的AD较高，但无论ICU类型如何，德国SARI ICU中碳青霉烯类的AD较高。在多变量分析中，住院时间是AD高于所用抗菌药物总量75%百分位数（OR 1.96/天）的独立风险因素;同样，对于AD高于碳青霉烯类（OR 1.90/天）和广谱青霉素类（OR 2.01/天）的75%百分位数。高使用糖肽类和喹诺酮类药物（AD >75%百分位数）与中心静脉导管（CVC）率（OR 1.14每CVC天每100患者日和1.16，分别）。
ObjectiveTo study antimicrobial use for benchmarking and ensuring quality of antimicrobial treatment and to identify risk factors associated with the high use of antimicrobials in German intensive care units (ICUs) through implementation of the SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in ICUs) system.DesignProspective, unit-based surveillance on antimicrobial use from February, 2000, until June, 2002. The data are standardised by use of the defined daily dose (DDD) for each antimicrobial defined by the WHO and by calculating use per 1000 patient days.SettingThe data were obtained from 35 German ICUs and stratified by type of ICU (medical, surgical, interdisciplinary).ResultsTo date, the project covers a total of 266,013 patient days in 744 reported ICU months and 354,356 DDDs. Mean antimicrobial use density (AD) was 1,332 DDD/1000 patient days and was correlated with length of stay. Penicillins with beta-lactamase inhibitor (AD 338.3) and quinolones (155.5) were the antimicrobial group with the highest ADs. Comparison with US ICARE (Intensive Care Antimicrobial Resistance Epidemiology)/AUR (Antimicrobial Use and Resistance) data revealed a higher AD for glycopeptides and 3rd generation cephalosporins in ICARE/AUR ICUs, but a higher AD for carbapenems in German SARI ICUs regardless of the type of ICU. In the multivariate analysis, length of stay was an independent risk factor for an AD above the 75% percentile of the total amount of antimicrobials used (OR 1.96 per day); likewise, for the AD above the 75% percentile of carbapenems (OR 1.90 per day) and penicillins with extended spectrum (OR 2.01 per day). High use of glycopeptides and quinolones (AD >75% percentile) correlated with central venous catheter (CVC) rate (OR 1.14 per CVC day per 100 patient days and 1.16, respectively).ConclusionThe SARI data on antimicrobials serve ICUs as a benchmark by which to improve the quality of antimicrobial drug administration and for international comparison.
影响因子：
4.9
作者：
GARNER, JS;JARVIS, WR;HUGHES, JM
通讯作者：
HUGHES, JM