ノート
感染制御チームによる週1回の抗菌薬適正使用支援の成果
キーワード:
infection control team,
antimicrobial stewardship,
antimicrobial use density,
days of therapy
2019 年 45 巻 1 号 p. 34-43
詳細
2019 年 45 巻 1 号 p. 34-43
In the field of bacterial infection control, improper use of antibiotics is one of the biggest factors to deteriorate the drug resistance of bacteria. Thus our hospital started AS round, which stands for ‘antimicrobial stewardship round’ once a week by the infection control team. In this report the contribution of ‘AS round’ is evaluated by the following categories:
1. Drug selection based on the sensitivity test results, 2. The dosage and administration of antibiotics use based on the pharmacokinetics/pharmacodynamics theory and renal function, 3. The induction rate of drug-resistant Pseudomonas aeruginosa, 4. Antimicrobial use density (AUD)/days of therapy (DOT), and 6. The 30-day mortality rate of patients infected by bacterial pneumonia.
The results of the AS round show that the dosage and administration of antibiotics has optimized year by year, and the submission rate of bacterial cultures has grown significantly. In addition, the requests for AS round by corresponding doctors and the proposal-acceptance-rate have also increased. Furthermore, broad-spectrum antibacterial drugs, which had been used for more than 8 days, and excessive use of narrow-spectrum antibacterial drugs has diminished. AUD/DOT, regarding carbapenem antibiotics, has also optimized. Moreover, the 30-day mortality rate of severe pneumonia has decreased significantly.
In conclusion, intervention-action by AS round, which optimizes antimicrobial drug use, has improved the outcome of infectious disease in our hospital.
