Benchmarking antimicrobial use to antimicrobial resistance: a comparative study of two hospitals using current National Healthcare Safety Network (NHSN) metrics.

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Carlos A Q Santos, Sarah Y Won, Ryan Dwyer, Caren Perez, William E Trick
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引用次数: 0

Abstract

Objective: We aimed to determine whether benchmarking antimicrobial use (AU) to antimicrobial resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation.

Design: We retrospectively measured AU (antimicrobial therapy days per 1,000 days present) and AU/AR ratios (specific antimicrobial therapy days per corresponding AR event) in two hospitals during 2020 through 2022. We then had antimicrobial stewardship committee members evaluate each AU and corresponding AU/AR value and indicate whether they believed it represented potential overuse, appropriate use, or potential underuse of the antimicrobials, or whether they could not provide an assessment.

Setting: Two acute-care hospitals.

Patients: Hospitalized patients.

Results: In semi-annual facility-wide analyses, echinocandins had a median AU/AR ratio of 658.5 therapy days per fluconazole-resistant Candida event in Hospital A, IV vancomycin had a median AU/AR ratio of 114.9 and 108.2 therapy days per methicillin-resistant Staphylococcus aureus event in Hospital A and B, respectively, and linezolid had a median AU/AR ratio of 33.8 and 88.0 therapy days per vancomycin-resistant Enterococcus event in Hospital A and B, respectively. When AU and AU/AR values were evaluated by stewardship committees, more respondents were able to assess antimicrobial use based on AU/AR values compared to AU values. Based on AU/AR ratios, most respondents identified potential overuse of echinocandins and IV vancomycin in Hospital A, and potential overuse of linezolid and IV vancomycin in Hospital B.

Conclusion: Select AU/AR ratios provided informative metrics to antimicrobial stewardship personnel, which can be used to motivate audits of antimicrobial administration to determine appropriateness.

基准抗菌素使用抗菌素耐药性:两家医院使用当前国家医疗安全网络(NHSN)指标的比较研究。
目的:我们的目的是确定使用选择的AU/AR比率对抗菌药物使用(AU)和抗菌药物耐药性(AR)进行基准测试是否比单独使用AU指标更具信息性。设计:我们回顾性地测量了2020年至2022年间两家医院的AU(每1000天的抗菌治疗天数)和AU/AR比率(每相应的AR事件的特定抗菌治疗天数)。然后,我们让抗菌药物管理委员会成员评估每个AU和相应的AU/AR值,并表明他们是否认为这代表了抗菌药物的潜在过度使用、适当使用或潜在使用不足,或者他们是否无法提供评估。环境:两家急诊医院。患者:住院患者。结果:在半年一次的全院范围的分析中,甲医院中,针珠菌素的AU/AR比中位数为658.5个耐氟康唑念珠菌事件,IV万古霉素的AU/AR比中位数分别为114.9和108.2个耐甲氧西林金黄色葡萄球菌事件,在甲医院和乙医院中,利奈唑胺的AU/AR比中位数分别为33.8和88.0个耐万古霉素肠球菌事件。当管理委员会评估AU和AU/AR值时,与AU值相比,更多的受访者能够根据AU/AR值评估抗菌素使用情况。根据AU/AR比率,大多数受访者发现A医院有可能过度使用紫珠白素和静脉万古霉素,b医院有可能过度使用利奈唑胺和静脉万古霉素。结论:选择AU/AR比率为抗菌药物管理人员提供了信息指标,可用于激励对抗菌药物管理的审计,以确定是否适当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
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