Improved antimicrobial interventions have benefits
Improved antimicrobial interventions have benefits
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DOI：
10.1128/jcm.39.8.2823-2828.2001
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发表时间：
2001-08-01
影响因子：
9.4
通讯作者：
Groesch, AA
中科院分区：
文献类型：
--
作者：
Barenfanger, J;Short, MA;Groesch, AA
研究表明，改善包括抗菌治疗在内的干预措施对患者有益。本研究的目的是前瞻性地评估改进干预措施的影响，通过（i）使用TheraTrac 2，一种计算机软件程序，将药敏试验结果立即电子链接到药房，并提醒药剂师潜在的干预措施，以及（ii）涉及微生物学主题的药剂师教育。研究小组制定了新的干预计划。对照组的干预措施与以前一样，通过手动审查敏感性测试数据的硬拷贝进行。在5个月的时间里，所有姓氏开头为A至K的住院患者为研究组，姓氏开头为L至Z的住院患者为对照组。进行了三项分析;一项分析（分析A）仅涉及接受干预的患者，一项分析（分析B）涉及所有进行了抗菌测试并与诊断相关组（DRG）匹配的患者，无论是否进行干预，一项分析（分析C）通过使用严重性校正数据涉及这些DRG匹配的患者。在分析A中，研究组的死亡率降低了4.8%，每位患者平均住院时间缩短了16.5天，每位患者的可变直接成本降低了20，886美元。这些差异均无统计学显著性。在分析B中，研究患者的死亡率高1.2%（P = 0.741），每例患者平均住院时间缩短2.7天（P = 0.035），每例患者可变直接成本减少2，626美元（P = 0.008）。在分析C中，研究患者的死亡率降低了1.4%，每位患者的住院时间缩短了1.2天，每位患者的可变直接成本减少了1，466美元。总之，该方案的实施节省了大量成本。
Studies have shown benefits to patients from improved interventions involving antimicrobial therapy. The purpose of the present study was to evaluate prospectively the impact of improved interventions by (i) the use of TheraTrac 2, a computer software program which electronically links susceptibility testing results immediately to the pharmacy and alerts pharmacists of potential interventions, and (ii) the education of pharmacists involving microbiologic topics. The study group had the new intervention program. The control group had interventions performed the way that they had previously been done by manually reviewing hard copies of susceptibility testing data. In a 5-month period, all inpatients whose last names began with A to K were the study group; inpatients whose last names began with L to Z were controls. Three analyses were done; one analysis (analysis A) involved only patients with interventions, one analysis (analysis B) involved all patients for whom antimicrobial testing was done and who were matched for diagnosis-related groups (DRGs), regardless of whether an intervention occurred, and one analysis (analysis C) involved these DRG-matched patients by using severity-adjusted data. In analysis A, the study group had a 4.8% decreased rate of mortality, an average of a 16.5-day decreased length of stay per patient, and $20,886 decreased variable direct costs per patient. None of these differences was statistically significant. In analysis B, the study patients had a 1.2% higher mortality rate (P = 0.741), an average of a 2.7-day decreased length of stay per patient (P = 0.035), and $2,626 decreased variable direct costs per patient (P = 0.008). In analysis C, the study patients had a 1.4% lower mortality rate, a 1.2-day decreased length of stay per patient, and $1,466 decreased variable direct costs per patient. In conclusion, the institution of this program caused substantial cost savings.