National Hospital Antibiotic Timing Measures for Pneumonia and Antibiotic Overuse
National Hospital Antibiotic Timing Measures for Pneumonia and Antibiotic Overuse
复制标题
全国医院针对肺炎和抗生素过度使用的抗生素使用时机措施
DOI：
10.1097/01.qmh.0000267448.32629.f8
复制
发表时间：
2007
影响因子：
1.2
通讯作者：
J. Cohn
中科院分区：
文献类型：
--
作者：
D. Drake;A. Cohen;J. Cohn
The development of drug-resistant bacteria from the overuse of antibiotics is a serious problem, with overutilization threatening to disarm caregivers and their patients even as together they face increasingly virulent strains of microbes. On the other hand, the speedy treatment of pneumonia with antibiotics is a firmly established, evidence-based practice, enshrined in Joint Commission on Accreditation for Healthcare Organizations Core Measures used in hospital accrediting and public reporting, and in Centers for Medicare and Medicaid Services (CMS) public-reporting and pay-for-performance hospital measures. This sets the stage for a potential conflict between (a) not doing the wrong thing by overprescribing antibiotics and (b) prescribing antibiotics on time for pneumonia. In November 2005, pneumonia antibiotic timing results were announced for the 133 top-performing hospitals in the first year of the 3-year CMS Hospital Quality Incentive Demonstration (HQID) pay-for-performance project, conducted in collaboration with Premier Inc, a hospital purchasing and informatics alliance. Premier client hospitals participating in the HQID also submit drug utilization and other comparative data to Premier for client access for benchmarking purposes; this makes it possible to see how the antibiotics specified for pneumonia are used by Premier hospitals for other conditions. In this study we look at where increased success in meeting the HQID pneumonia antibiotic timing measure is tied to an increase in antibiotic use for conditions where antibiotics are unwarranted—with the potential for promoting antibiotic resistance.
