抗 MRSA 薬使用量に及ぼす感染制御部による介入の影響

抄録

This study was undertaken in order to evaluate the effectiveness of interventions by the Department of Infection Control and Prevention in promoting the proper use of antibiotic drugs for methicillin resistant Staphylococcus aureus (MRSA) prescribed to inpatients.We performed 3 interventions : 1.Protocol improvement for anti-MRSA drug use ; 2.Change in alcohol-based handrub and training in hand hygiene and 3.Devised reporting system for drug use.The effects of the interventions were determined by segmented regression analysis of interrupted time series for drug usage and cost before and after the interventions were commenced.
The change in slope of drug use was -1.05 vials/1000 inpatients per month (95% Confidence interval (C.I.) -2.84,0.74)and the change in level was -8.21 vials/1000 inpatients (95% C.I.-14.67,-1.75).There was a significant decrease in the ratio of the patients receiving anti-MRSA drugs to MRSA incidence between before and after the interventions.These results suggested that usage of anti-MRSA drugs was immediately reduced by the interventions to promote the proper use of drugs.An ordinary estimate of reduction in costs was ¥29 million per year while a more conservative estimate produced a decrease of ¥20 million per year.
These findings suggest that monitoring antimicrobial use and promoting the proper use of antibiotics for MRSA are important roles for pharmacists to perform.