Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital.
Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital.
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DOI：
10.1016/j.jegh.2014.06.003
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发表时间：
2015-06
影响因子：
7.3
通讯作者：
Simor A
中科院分区：
文献类型：
--
作者：
Lee C;Walker SA;Daneman N;Elligsen M;Palmay L;Coburn B;Simor A
目的：不适当的抗菌药物使用可以促进抗菌药物耐药性，这与患者发病率和死亡率增加有关。确定抗菌药物使用模式可以提供数据，从而可以进行有针对性的抗菌药物管理干预。主要目的是确定三级护理教学医院急性和长期护理患者的抗菌药物使用率。方法：2012年7月19日进行了一项点患病率研究。使用定制的综合管理数据库（SPIRIT）和前瞻性图表审查收集了抗菌药物使用、处方适应症、治疗持续时间和感染性疾病或抗菌药物管理咨询频率的数据。结果：31%的急性护理和4%的长期护理患者分别订购了一种或多种抗菌药物。呼吸道和尿路感染是急性和长期护理中最常见的抗菌治疗适应症。约25%的手术预防性医嘱的处方时间超过24小时。结论：这项前瞻性时点患病率调查提供了大型三级护理教学医院内抗菌药物使用的重要基线信息，并确定了未来抗菌药物管理举措的潜在目标。应考虑进行多中心点患病率调查，以确定加拿大抗菌药物使用的模式，并建立国际抗菌药物监测的第一步。
Objectives: Inappropriate antimicrobial use can promote antimicrobial resistance, which is associated with increased patient morbidity and mortality. Identifying the pattern of antimicrobial use can provide data from which targeted antimicrobial stewardship interventions can be made. The primary objective was to identify the prevalence of antimicrobial use at a tertiary care teaching hospital with both acute and long-term care patients. Methods: A point prevalence study was conducted on July 19th, 2012. Data on antimicrobial utilization, indication for prescribing, duration of therapy, and frequency of infectious disease or antimicrobial stewardship consultations were collected using a customized integrated stewardship database (SPIRIT) and prospective chart review. Results: One or more antimicrobial agents were ordered in 31% and 4% of acute care and long-term care patients, respectively. Respiratory and urinary tract infections were the most common indication for antimicrobial therapy in both acute and long-term care. About 25% of surgical prophylaxis orders were prescribed for greater than 24 h. Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.