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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
한국병원약사회 병원약사회지 병원약사회지 제35권 제1호
발행연도
2018.1
수록면
30 - 38 (9page)

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초록· 키워드

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Background : Pharmacists are key members of the Antimicrobial Stewardship Program (ASP) team playing a critical role in improving antimicrobial use. A pharmacy intervention program built in the hospital electronic medical records for ASP (ASP-EMR) was developed and the sustained impact of the pharmacist-enhanced ASP was described in this study as measured by antimicrobial use and costs and the proportion of inappropriate antimicrobial prescriptions. Methods : An interrupted time series with segmented regression analysis was conducted in 3 stages; 1-preintervention; 2-pharmacists’participation in ASP without ASP-EMR and 3-pharmacists’participation in ASP with ASP-EMR. Using EMR data from a tertiary care hospital, the information on the prescribed antimicrobial agents was extracted 2009-2016. The pharmacist-enhanced ASP intervention started in March 2012. Prospective audit and feedback were triggered by ASP-EMR and the program was led by 1 clinical pharmacist and 1 pharmacy resident. Changes in the outcomes were compared before and after the pharmacist intervention with or without ASP-EMR. Results : The development of pharmacy intervention program via ASP-EMR was completed in May 2016. After the pharmacist-enhanced ASP intervention, the rate of broad spectrum antimicrobial agents decreased as measured by daily defined doses (DDDs)/1,000 inpatient days (120.1 in Stage 1 and 103.5 in stage 3). In Stage 3, inappropriate duplication of anaerobic coverage was decreased as compared to Stage 1 as measure by days of therapy (DOT)/length of therapy (LOT) (1.13 in Stage 1 and 1.01 in Stage 3). The intervention on the intravenous (IV)-to oral conversion of quinolones increased the proportion of oral ciprofloxacin prescription and the estimated cost avoidance from interventions was 4,291,797 won in Stage 2 and 5,208,979 won in Stage 3. Conclusion : The implementation of the pharmacists’participation in ASP at a tertiary care hospital in Korea was associated with a positive impact on antimicrobial use, spending, and inappropriate prescriptions

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참고문헌 (9)

참고문헌 신청
Dellit TH / 2007 / Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship / Clin Infect Dis 44(2):159~177 Crossref Angeliki P Messina / 2015 / Antimicrobial stewardship with pharmacist intervention improves timeliness of antimicrobials across thirty three hospitals in south Africa / Infect Dis Ther 41(Suppl1):5~14 google schola Apisarnthanarak A / 2015 / Design and analysis of a pharmacist enhanced antimicrobial stewardship program in Thailand / Am J Infect Control 43:956~959 Crossref World Health Organization. Collaborating Centre for Drug Statistics Methodology / 2004 / Anatomical Therapeutic Chemical (ATC) Index with Defined Daily dose (DDD) google schola Morris A / 2012 / Use of a Structured Panel Process to Define Quality Metrics for Antimicrobial Stewardship Programs / Infection Control and Hospital Epidemiology 33(5):500~506 Crossref

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