时不我待。没有借口拖延抗菌药物管理计划的实施:通过间断时间序列分析(2017-2022 年)了解影响、可持续性、复原力和效率。

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-05-15 eCollection Date: 2024-06-01 DOI:10.1093/jacamr/dlae072
Giovanni Del Fabro, Sergio Venturini, Manuela Avolio, Giancarlo Basaglia, Astrid Callegari, Igor Bramuzzo, Barbara Basso, Chiara Zanusso, Anna Rizzo, Giuseppe Tonutti, Michele Chittaro, Eva Fiappo, Maurizio Tonizzo, Massimo Crapis
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引用次数: 0

摘要

导言:世界卫生组织于 2014 年宣布抗菌药物耐药性(AMR)是一个重大问题,从而引发了确保负责任地使用抗生素的倡议。在人类医学中,医院的抗菌药物管理计划(ASP)在抗击 AMR 方面发挥着举足轻重的作用。尽管有证据支持抗菌药物管理计划在优化抗菌药物使用方面的有效性,但缺乏资源往往成为限制其推广和使用的借口。本文对意大利东北部一个医疗保健地区实施的 ASP 进行了为期 6 年的全面分析报告:方法:对数据进行了回顾性收集,以评估该计划对抗生素消耗量的影响(以DDDs/100个患者日表示)、其长期可持续性、在COVID-19大流行期间的恢复能力以及ASP的效率(工作量与人力资源之间的关系):结果:抗生素消耗量总体大幅减少(-14%),尤其是氟喹诺酮类(-64%)和碳青霉烯类(-68%),显示了该计划的影响力。随着时间的推移,抗生素消费的持久趋势和生态分析证实了可持续性。即使在具有挑战性的 COVID-19 大流行期间,ASP 仍能保持良好的趋势,从而展示了其复原力。在 2021 年之前,尽管人力资源一直保持不变,但现场咨询数量仍在增加,这凸显了该计划的效率:本研究为资源节约型 ASP 的长期成功提供了见解,强调了在 AMR 等全球健康挑战的背景下,长期承诺在促进负责任地使用抗生素方面的关键作用。
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Time is running out. No excuses to delay implementation of antimicrobial stewardship programmes: impact, sustainability, resilience and efficiency through an interrupted time series analysis (2017-2022).

Introduction: The WHO declared antimicrobial resistance (AMR) a significant concern in 2014, sparking initiatives to ensure responsible antibiotic use. In human medicine, Antimicrobial Stewardship Programmes (ASPs) in hospitals play a pivotal role in combating AMR. Although evidence supports the effectiveness of ASPs in optimizing antimicrobial use, often the lack of resources becomes an excuse to limit their dissemination and use. This paper provides a comprehensive report on a 6-year analysis of an ASP implemented in a healthcare region in north-east Italy.

Methods: A retrospective data collection was conducted to assess the programme's impact on antibiotic consumption expressed as DDDs/100 patient-days, its sustainability over time, resilience during the COVID-19 pandemic and the efficiency of the ASP (relationship between workload and human resources).

Results: A substantial overall reduction in antibiotic consumption (-14%), particularly in fluoroquinolones (-64%) and carbapenems (-68%), was demonstrated, showcasing the programme's impact. Sustainability was confirmed through enduring trends in antibiotic consumption and ecological analysis over time. The ASP demonstrates resilience by maintaining positive trends even amid the challenging COVID-19 pandemic. Efficiency was underscored by an increase in on-site consultations despite consistent human resources until 2021.

Conclusions: This study offers insights into the prolonged success of a resource-efficient ASP, emphasizing the crucial role of long-term commitment in fostering responsible antibiotic use in the context of global health challenges such as AMR.

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