管理:它正在病毒式传播

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-03-11 DOI:10.1016/j.infpip.2024.100356
Abigail Jenkins , Jubeyr Ahmed , Andrew Bosworth , I Michael Kidd , Husam Osman , Sowsan F. Atabani
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引用次数: 0

摘要

导言从历史上看,抗菌药物管理(AMS)就是对抗生素的合理使用。抗菌药物管理制度在欧洲和美国被广泛采用;最近,抗真菌药物管理制度的发展势头越来越好,但对抗病毒药物管理制度的描述却很少。方法 2022 年 6 月,英国宣布阿昔洛韦注射液(ACV IV)出现供应问题。为了审查并为最需要的患者保留肠外 ACV,UHBFT 的药剂师和病毒学家对处方治疗时间超过 48 小时的患者实施了专家审查。这种审查最初持续 10 周,并收集了有关所提供建议、建议是否被接受以及完成审查所需时间的数据。结果与干预前或干预后的水平相比,AVS 查房使静脉注射 ACV 的消耗量减少了一半,一半以上的患者被建议停止或改用口服疗法。四分之一的复查提供了诊断和采样指导,而其余的干预措施则更加注重监管。几乎在所有情况下,临床团队都欣然接受了监管建议。由于临床医生的积极反馈及其对供应的有效管理,抗病毒药物管理(AVS)计划于 2023 年 6 月再次引入。在英国伯明翰大学附属医院定期开展的抗病毒药物管理计划现已成熟,并计划在其他医院实施。
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Stewardship: it's going viral

Introduction

Historically, antimicrobial stewardship (AMS) has considered the judicious use of antibiotics. AMS is widely adopted across Europe and the US; recently antifungal AMS is gaining momentum but antiviral AMS has been little described. Here we describe the introduction of AMS virology reviews at University Hospitals Birmingham (UHBFT); a novel concept and an opportunity to broaden the beneficial aspects of AMS to virology, termed anti-viral stewardship (AVS).

Method

In June 2022, a UK supply issue with aciclovir injection (ACV IV) was announced. In order to review and preserve parenteral ACV for those in greatest need, UHBFT pharmacist and virologists implemented a specialist review for patients prescribed more than 48 hours of treatment. This review initially lasted 10 weeks and data was collected on the advice offered, whether it was accepted, and time required completing the review.

Results

AVS rounds halved IV ACV consumption, compared to pre or post intervention levels, with more than half of patients advised to stop or switch to oral therapy. Diagnostics and sampling guidance was offered in one quarter of reviews, whilst the remaining interventions were more stewardship focused. In almost all cases stewardship advice was readily accepted by clinical teams. Due to positive feedback from clinicians and its effective management of supply, the anti-viral stewardship (AVS) programme was re-introduced in June 2023.

Conclusions

Antiviral AMS rounds provide an opportunity to optimise sampling, diagnosis and improve patient management. Introduction of regular AVS at UHBFT are now well established and plan to be implemented in other hospitals.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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