专项整治减少了抗菌药的使用和费用：65家公立医院的数据（2010-2014年）
最近Plos One刊登了评价我国抗菌药专项整治的文章。看上去效果还不错。pubmed可以下载全文。不过结果好像都是正面的，没有说明还有哪些地方是需要注意和改进的。PLoS One. 2015 Mar 13;10(3):e0118868. doi: 10.1371/journal.pone.0118868. eCollection 2015.
Significant reduction of antibiotic consumption and patients' costs after an action plan in china, 2010-2014.
Bao L1, Peng R1, Wang Y1, Ma R1, Ren X1, Meng W2, Sun F3, Fang J4, Chen P5, Wang Y6, Chen Q7, Cai J8, Jin J9, Guo J10, Yang S11, Mo X12, Zhang E13, Zhang Y14, Lu Z15, Chen B16, Yue X17, Zhu M18, Wang Y19, Li X20, Bian Y21, Kong S22, Pan W23, Ding Q24, Cao J25, Liu R26, Chen N27, Huang X28, B A29, Lyu H30.
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Abstract
INTRODUCTION:
On July 1, 2011, the Chinese government launched a national Action Plan for antibiotic stewardship targeting antibiotic misuse in public hospitals. The aim of this study was to evaluate the impacts of the Action Plan in terms of frequency and intensity of antibiotic utilization and patients costs in public general hospitals.
METHODS:
Administrative pharmacy data from July 2010 to June 2014 were sampled from 65 public general hospitals and divided into three segments: (1) July 2010 to June 2011 as the preparation period; (2) July 2011 to June 2012 as the intervention period; and (3) July 2012 to June 2014 as the assessment period. The outcome measures included (1) antibiotic prescribing rates; (2) intensity of antibiotic consumption; (3) patients costs; and (4) duration of peri-operative antibiotic treatment in clean surgeries of thyroidectomy, breast, hernia, and orthopedic procedures. Longitudinal and cross-sectional analyses were conducted.
RESULTS:
Longitudinal analyses showed significant trend changes in the frequency and intensity of antibiotic consumption, the patients' costs on antibiotics, and the duration of antibiotic treatment received by surgical patients undergoing the 4 clean procedures during the intervention period. Cross-sectional analyses showed that the antibiotic prescribing rates were reduced to 35.3% and 12.9% in inpatient and outpatient settings, that the intensity of antibiotic consumption was reduced to 35.9 DDD/100 bed-days, that patients' costs on antibiotics were reduced significantly, and that the duration of peri-operative antibiotic treatment received by surgical patients undergoing the 4 types of clean procedures decreased to less than 24 hour during the assessment period.
CONCLUSION:
The Action Plan, as a combination of managerial and professional strategies, was effective in reducing the frequency and intensity of antibiotic consumption, patients' costs on antibiotics, and the duration of peri-operative antibiotic treatment in the 4 clean surgeries.
PMID: 25767891 PMCID: PMC4359138 Free PMC Article
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