急诊医院的抗菌药物管理计划:意大利和西班牙对结构、流程和结果指标的多中心评估

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-05-24 DOI:10.1016/j.jiph.2024.05.045
Giuseppina Lo Moro , Noemi Marengo , Alessandro Mara , José Ramón Paño Pardo , Sergi Hernandez , Ester Fusté , Miquel Pujol , Carla Maria Zotti , Enric Limón , Costanza Vicentini
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引用次数: 0

摘要

背景抗菌药物管理(AMS)计划在欧洲各地的实施情况各不相同。本研究的主要目的是比较两个欧洲地区的抗菌药物管理计划。方法 在皮埃蒙特(意大利)和加泰罗尼亚(西班牙)开展了一项回顾性观察研究。通过 2021 年的结构和流程指标对 AMS 项目进行了比较。代用结果指标(抗菌药物使用量、酒精消毒剂消耗量、抗菌药物耐药性、AMR)从 2017 年到 2021 年的变化描述了大流行的影响。加泰罗尼亚的结构得分较高(p <0.001),两项指标的分散程度较低。最需要改进的方面是问责制(皮埃蒙特)和战略多样化(加泰罗尼亚)。总体而言,各地区报告的成果指标变化一致。2020 年抗菌剂使用量有所下降,2021 年恢复到接近大流行前的水平。酒精消毒剂的使用量在 2020 年激增,随后有所下降,但仍高于大流行前的水平。结论加泰罗尼亚的集中化方法确保了所有设施始终如一地实现质量目标,但可能会限制针对具体设施的策略。在皮埃蒙特,与往年一样,问责制仍然是最关键的因素之一。大流行并没有对急性呼吸系统综合症的代用结果指标产生重大影响。然而,有关 AMR 的数据表明,对这一问题保持警惕仍然至关重要。
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Antimicrobial stewardship programs in acute-care hospitals: A multicenter assessment of structure, process, and outcome indicators in Italy and Spain

Background

Antimicrobial stewardship (AMS) programs have been differently implemented across Europe. This study primarily aimed to compare AMS in two European regions. Secondarily, the study explored the COVID-19 pandemic impact on surrogate outcome indicators of AMS.

Methods

A retrospective observational study was conducted in Piedmont (Italy) and Catalonia (Spain). AMS programs were compared through structure and process indicators in 2021. Changes in surrogate outcome indicators (antimicrobial usage; alcohol-based sanitizer consumption; antimicrobial resistance, AMR) from 2017 to 2021 described the pandemic impact.

Results

Seventy-eight facilities provided structure and process indicators. Catalonia showed better structure scores (p < 0.001) and less dispersion in both indicators. The greatest areas to improve were accountability (Piedmont) and diversification of strategies (Catalonia). Overall, the regions reported consistent changes in outcome indicators. Antimicrobial usage decreased in 2020, returning to near-pre-pandemic levels in 2021. Alcohol-based sanitizer consumption surged in 2020, then dipped remaining above pre-pandemic levels. AMR trends were minimally affected.

Conclusions

The centralized approach of Catalonia ensured consistent attainment of quality objectives across all facilities, but it may limit facility-specific strategies. In Piedmont, accountability remain one of the most critical factors as in previous years. The pandemic did not substantially disrupt surrogate outcome measures of AMS. However, the data on AMR suggest that maintaining vigilance against this issue remains paramount.

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来源期刊
Journal of Infection and Public Health
Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
13.10
自引率
1.50%
发文量
203
审稿时长
96 days
期刊介绍: The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.
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