儿科药学杂志2026，Vol.32Issue(2)：19-24,6.DOI:10.13407/j.cnki.jpp.1672-108X.2026.02.005
临床药师主导的抗菌药物科学化管理有效降低妇儿专科医院抗菌药物使用强度
Clinical Pharmacist-Led Antimicrobial Stewardship in Effective Reduction of Antibacterial Use Density in the Women and Children's Hospital
摘要
Abstract
Objective:To explore the effectiveness of multidisciplinary antimicrobial stewardship(AMS)led by clinical pharmacists in reducing the antibacterial use density(AUD)in the women and children's hospital.Methods:A clinical pharmacist-led AMS project was implemented,and the plan-do-check-act(PDCA)method was applied.The AUD,antimicrobial utilization rate in inpatients,proportion of inpatient antibiotic costs,proportion of special-class antibiotics,and pathogen detection rate of inpatients before antimicrobial therapy were collected to evaluate the effects.Results:Before and after the implementation of AMS project,AUD of inpatients decreased from 24.34 defined daily dose system(DDDs)to 16.65 DDDs from 2020 to 2023,the antimicrobial utilization rate in inpatients decreased from 42.60％to 37.28％,the proportion of inpatient antibiotic costs decreased from 16.87％to 9.41％,the pathogen detection rate of inpatients before antimicrobial therapy increased from 64.64％to 81.94％,the proportion of special-class antibiotics decreased from 32.65％to 24.82％,the hospital infection case rate decreased from 0.96％to 0.88％,the multidrug-resistant organism detection rate decreased from 19.23％to 13.26％,but the difference of surgical site infection rate between two groups was not statistically significant(P=0.512).Subsequent interrupted time series(ITS)analysis demonstrated that in the short term,the implementation of AMS project significantly decreased the AUD,proportion of inpatient antibiotic costs,and proportion of special-class antibiotics,but significantly increased the pathogen detection rate of inpatients before antimicrobial therapy.In the long term,the implementation of AMS project was associated with a significant reduction in the proportion of inpatient antibiotic costs and proportion of special-class antibiotics.Meanwhile,no significant short-term or long-term effects of the implementation of AMS project were observed on antimicrobial utilization rate in inpatients.Conclusion:The AMS management model led by clinical pharmacists and based on PDCA is effective in promoting the rational use of antibiotics in the women and children's hospital.关键词
PDCA循环/抗菌药物使用强度/妇儿专科医院/合理用药Key words
PDCA cycle method/antibacterial use density/women and children's hospital/rational drug use分类
医药卫生引用本文复制引用
杨金连,肖楚瑶,李丽娟,曹晓均,丁春光,赵丹洋,郭巧芝,周轶,莫小兰,邓后亮,李晓君,欧阳珊,岑菡婧,梁倩莹,魏媛怡,卢嘉丽,吴玮哲..临床药师主导的抗菌药物科学化管理有效降低妇儿专科医院抗菌药物使用强度[J].儿科药学杂志,2026,32(2):19-24,6.基金项目
吴阶平医学基金会临床科研专项资助基金,编号320.6750.2022-20-26 （）
广州市科学技术局2023年重点研发计划项目(2023年度农业和社会发展科技专题),编号SL2022B03J01382 （2023年度农业和社会发展科技专题）
中国药学会医院药学专委会医院药学青年人才项目,编号CPA-Z05-ZC-2021-003. （）
