Practices to improve antimicrobial use at 47 US hospitals: The status of the 1997 SHEA/IDSA position paper recommendations
Practices to improve antimicrobial use at 47 US hospitals: The status of the 1997 SHEA/IDSA position paper recommendations
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DOI：
10.1086/501754
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发表时间：
2000-04-01
影响因子：
4.5
通讯作者：
McGowan, JE
中科院分区：
文献类型：
--
作者：
Lawton, RM;Fridkin, SK;McGowan, JE
目的：了解美国部分医院抗菌药物处方改进计划的实施情况。设计：横断面调查。对象和地点：参与第三期重症监护抗菌药物耐药性流行病学项目的所有47家医院的药房和感染控制人员。结果：所有47家医院都有一些改善抗菌药物使用的计划，但报告的做法差异很大。所有人都使用处方，43人(91%)将其与其他至少三项评估的抗微生物药物使用政策之一一起使用：停用令、限制和基于标准的临床实践指南(CPGs)。报告的CPG最多(70%)，其次是停止令(60%)和限制政策(40%)。虽然咨询传染病内科医生(70%)或药剂师(66%)通常被用来影响最初的抗菌药物选择，但很少(40%)报告了衡量这些咨询依从性的系统。结论：在大多数接受调查的医院，改善抗菌药物使用的做法。尽管存在，但根据美国卫生保健流行病学学会和美国传染病学会联合立场文件中的建议，这些研究是不充分的。美国医院的抗菌素使用管理仍有改进的空间。
OBJECTIVE: To determine the status of programs to improve antimicrobial prescribing at select US hospitals.DESIGN: Cross-sectional survey.PARTICIPANTS AND SETTING: Pharmacy and infection control staff at all 47 hospitals participating in phase 3 of Project Intensive Care Antimicrobial Resistance Epidemiology.RESULTS: All 47 hospitals had some programs to improve antimicrobial use, but the practices reported varied considerably. All used a formulary, and 43 (91%) used it in conjunction with at least one of the other three antimicrobial-use policies evaluated: stop orders, restriction, and criteria-based clinical practice guidelines (CPGs). CPGs were reported most commonly (70%), followed by stop orders (60%) and restriction policies (40%). Although consultation with an infectious disease physician (70%) or pharmacist (66%) was commonly used to influence initial antimicrobial choice, few (40%) reported a system to measure compliance with these consultations.CONCLUSIONS: In most hospitals surveyed, practices to improve antimicrobial use. although present, were inadequate based on recommendations in a Society for Healthcare Epidemiology of America and Infectious Disease Society of America joint position paper. There is room to improve antimicrobial-use stewardship at US hospitals.