Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure
Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure
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DOI：
10.1111/apa.14337
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发表时间：
2018-10-01
期刊：
影响因子：
3.8
通讯作者：
Dempsey, E. M.
中科院分区：
文献类型：
--
作者：
McCarthy, K. N.;Hawke, A.;Dempsey, E. M.
目的：抗菌药物管理在确保采用适当的药物、剂量、途径和持续时间以提供充分的治疗，同时最大限度地减少不必要的抗生素使用风险方面发挥着重要作用。建议将抗生素使用监测与处方者反馈作为高影响力的管理干预措施。本研究的目的是减少不必要的抗菌药物的使用在新生儿unit.Methods：进行前瞻性审计，以评估遵守抗菌药物指南。在此之后，应用教育干预措施，将电子处方引入新生儿病房，并进行重新审核。主要结果是减少治疗天数（DOT）。结果：有312新生儿入院。DOT/1000患者日的主要结局总体显着减少，从572个DOT减少到417个DOT。这意味着抗生素使用总量减少了27%。在阴性脓毒症评估中，延长抗生素治疗疗程>36小时从82 DOT减少到7.5 DOT。同样，治疗疗程大于5天的培养阴性脓毒症从46.5 DOT减少到7 DOT。结论：监测抗生素处方数据可以提供有用的见解抗生素使用的趋势，也告知临床医生的潜在领域，抗生素的使用可以安全地减少。
Aim: Antimicrobial stewardship plays an important role in ensuring that the appropriate drug, dose, route and duration are employed to provide adequate treatment while minimising the risks of unnecessary antibiotic use. Surveillance of antibiotic use with prescriber feedback is recommended as a high-impact stewardship intervention. The aim of this study was to reduce unnecessary antimicrobial use in a neonatal unit.Methods: A prospective audit was performed to assess compliance with antimicrobial guidelines. Following this, educational interventions were applied, electronic prescribing was introduced to the neonatal unit, and re-audit was performed. The primary outcome was a reduction in days of therapy (DOT).Results: There were 312 neonatal admissions. There was a significant overall reduction in the primary outcome of DOT/1000 patient days from 572 to 417 DOT. This represents a 27% reduction in total antibiotic use. Prolonged antibiotic treatment courses >36 hours in negative sepsis evaluations were reduced from 82 DOT to 7.5 DOT. Similarly, treatment courses greater than five days for culture-negative sepsis were reduced from 46.5 DOT to 7 DOT.Conclusion: Monitoring antibiotic prescribing data can provide useful insights into the trends of antibiotic use and also inform clinicians of potential areas where antibiotic use may be safely reduced.