Abstract
Antimicrobial stewardship programs, including ‘formulary restriction and preauthorization’ and ‘intervention and feedback,’ are strategies known to promote the appropriate use of antimicrobial agents. In this article, we reviewed our approach based on a strategy of antimicrobial stewardship.
An initial loading dose of teicoplanin is required to reach the optimal trough concentration. Therefore, we performed individual adjustment of the initial loading dose of teicoplanin based on population pharmacokinetics. Both the trough concentration and the proportion of patients who showed the optimal plasma concentration were higher in the individual loading dose regimen than in the conventional loading dose regimen.
To investigate the risk factors associated with the development of thrombocytopenia in patients who received intravenous linezolid therapy, risk factors associated with linezolid induced thrombocytopenia were retrospectively identified via logistic regression analysis. In multivariate analysis, daily dose (≧22 mg/kg) was a significant risk factor for thrombocytopenia associated with linezolid therapy.
Since August 2009, our hospital has established a review system for checking prescription in all patients receiving antimicrobial injections according to the intervention and feedback. Our intervention was found to be effective in shortening hospital stay, reducing the MRSA ratio, and saving medical expenses. Furthermore, frequent monitoring resulted in an increase in the frequency of recommendation by infection control team, reduction of antibiotic consumption, and further shortening of antibiotic therapy and hospital stay.
From these findings, we concluded that our established approach based on the antimicrobial stewardship guideline were useful for the promotion of the appropriate use of antimicrobial agents.
