Antimicrobial prescribing in residential homes
Antimicrobial prescribing in residential homes
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DOI：
10.1093/jac/dks085
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发表时间：
2012-07-01
影响因子：
5.2
通讯作者：
Hughes, Carmel
中科院分区：
文献类型：
--
作者：
McClean, Pamela;Tunney, Michael;Hughes, Carmel
到目前为止，在居民家庭中的研究一直有限，系统和局部抗菌药处方的程度在很大程度上是未知的。这项研究的目的是调查北爱尔兰(NI)住宅家庭中抗菌药物处方的情况。点流行研究(PPS)分别于2010年11月(PPS1)和2011年4月(PPS2)在30个住宅家庭中完成。从护理计划、用药记录和工作人员中获得与抗菌药物处方、设施和居民特征有关的数据，并进行描述性分析，PPS1和PPS2系统抗菌药物处方的点数分别为9.4和9.2(两个PPSs期间的范围为0.033.3)。甲氧苄啶是最常用的全身抗菌药物，其主要适应症是预防尿路感染。近25%的全身抗菌药是以不适当的剂量开出的。PPS1和PPS2局部抗菌药物处方的点位流行率分别为6.4(0.022.2)和5.9(0.021.1)。最常用的局部抗菌药物是PPS1中的氯霉素眼用制剂和PPS2中的呋西地酸皮肤制剂；这些局部抗菌药物的治疗通常会延长。超过25%的全身抗菌药和55%的局部抗菌药是在电话咨询后开始使用的，而不是面对面的咨询。与其他国家的疗养院(特别是疗养院)相比，NI的养老院系统抗菌药处方的流行率相对较高。就处方的剂量和使用时间而言，全身和局部使用抗菌药物并不总是合适的。显然，NI目前采用的战略不足以确保在这种环境下谨慎地开出抗菌药处方。
Research in residential homes has been limited to date and the extent of systemic and topical antimicrobial prescribing is largely unknown. The aim of this study was to investigate antimicrobial prescribing in residential homes in Northern Ireland (NI).Point prevalence studies (PPSs) were completed in November 2010 (PPS1) and April 2011 (PPS2) in 30 residential homes. Data were obtained from care plans, medication administration records and staff in relation to antimicrobial prescribing and facility and resident characteristics, and analysed descriptively.The point prevalence of systemic antimicrobial prescribing was 9.4 in PPS1 and 9.2 in PPS2 (range 0.033.3 during both PPSs). Trimethoprim was the most commonly prescribed systemic antimicrobial and the main indication was the prevention of urinary tract infections. Almost 25 of systemic antimicrobials were prescribed at inappropriate doses. The point prevalence of topical antimicrobial prescribing was 6.4 (range 0.022.2) in PPS1 and 5.9 (range 0.021.1) in PPS2. The most commonly prescribed topical antimicrobials were chloramphenicol eye preparations in PPS1 and fusidic acid skin preparations in PPS2; treatment with these topical antimicrobials was generally prolonged. More than 25 of all systemic and 55 of all topical antimicrobials were initiated following telephone consultations as opposed to face-to-face consultations.The prevalence of systemic antimicrobial prescribing in residential homes in NI is relatively high compared with care homes (particularly nursing homes) in other countries. Systemic and topical antimicrobial prescribing is not always appropriate in terms of the doses prescribed and the duration of use. It is apparent that current strategies employed in NI are insufficient to ensure prudent antimicrobial prescribing within this environment.