抗菌药物管理团队专职药剂师实施的所有注射用例的干预评估

Sachiyo Obana, Akari Yoshida, Ayako Chimori, Takakazu Kuwana, K. Ueno, Hidekatsu Fukuda, Satoshi Takashima, Mitsunari Yamamoto
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摘要

抗菌药物管理小组(AST)在协助治疗传染病方面发挥着重要作用。2018年8月,我们启动了AST专职药剂师项目,重点对静脉注射抗生素前患者和所有静脉注射抗生素患者进行会诊。在本研究中,我们调查了全职药剂师干预对抗菌药物管理前(2017年8月至2018年7月)和后(2018年8月至2019年7月)干预的影响。在干预前和干预后,与全职药剂师咨询的总次数分别显著增加到71次和252次。干预前后差异无统计学意义,干预前后分别提出处方改进建议69条(合格率85.5%)和230条(83.5%),差异有统计学意义(P = 0.852)。干预前后30天死亡率无差异。此外,与干预前2017年8月至2018年7月期间相比,干预期间碳青霉烯类抗生素的抗菌药物使用密度(AUD) /治疗天数(DOT)从0.73降至0.58 (P = 0.004)。基于这些结果,我们建议实施积极的咨询和干预措施,由专职药剂师有助于促进适当的治疗。
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Intervention Evaluation for All Injectable Antimicrobial Use Cases Practiced by Full-time Pharmacist in the Antimicrobial Stewardship Team
The antimicrobial stewardship team (AST) plays an important role in assisting with the treatment of infectious diseases. In August 2018, we started a program to dedicate a pharmacist to the AST and performed consultations focusing on patients before receiving intravenous antibiotics and all patients receiving intravenous antibiotics. In this study, we inves-tigated the impact of full-time pharmacist interventions on antimicrobial stewardship pre- (August 2017 – July 2018) and post- (August 2018 – July 2019) intervention. The total number of consultations with the full-time pharmacist increased significantly at 71 and 252 consultations pre- and post-intervention, respectively. There was no significant difference in the intervention, and a total of 69 (pass rate 85.5 % ) and 230 (83.5 % ) prescription improvement proposals were made pre- and post-intervention, respectively ( P = 0.852). There was no difference in 30-day mortality pre- and post-intervention. Additionally, as compared to the period from August 2017 to July 2018, that is, before the intervention, Antimicrobial Use Density (AUD) / Days of Therapy (DOT) for carbapenem antibiotics decreased from 0.73 to 0.58 during the intervention period ( P = 0.004). Based on these results, we suggest that the implementation of aggressive consultations and interventions by the full-time pharmacist is useful for promoting the appropriate treatment.
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