PO-llution control: a cross-sectional study on the role of antimicrobial stewardship in reducing healthcare's carbon footprint.

IF 3.3 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2025-08-28 eCollection Date: 2025-08-01 DOI:10.1093/jacamr/dlaf146
Saied Ali, Sadhbh Gash, Niamh Weir, Karen Burns, Binu Dinesh, Helene Mcdermott, Fidelma Fitzpatrick, Sinead O'Donnell, Ciara O'Connor
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引用次数: 0

Abstract

Objectives: To evaluate the environmental impact of prolonged IV antimicrobial courses and identify opportunities for improved antimicrobial stewardship (AMS) practices.

Methods: A retrospective cross-sectional study was conducted using AMS ward-round data from January 2023 to December 2024 at a tertiary hospital in Dublin, Ireland. Data on IV antimicrobial prescriptions, AMS recommendations for discontinuation or IV to oral switch (IVOS) and prescriber acceptance were reviewed. A life cycle assessment, informed by published literature, was used to estimate the carbon footprint associated with IV use.

Results: Of 1929 antimicrobial prescriptions reviewed, 58% (n = 1119) were being administered IV. Among 435 IV prescriptions with AMS, recommendations to stop (n = 357) or IVOS (n = 78), 229 (52.6%) were accepted, resulting in a reduction of 106.5 kg of clinical waste and 261.2 kg carbon dioxide equivalents (CO₂e) emissions. The remaining 206 IV prescriptions (47.4%) were categorized as prolonged IV prescriptions, generating 98.8 kg of clinical waste and 245.8 kg CO₂e; averaging 0.48 kg of waste and 1.19 kg CO₂e per prescription. To contextualize, the carbon footprint of each prolonged prescription equates to driving 6.2 km, performing 10 chest X-rays or operating a 10 W light-emitting diode bulb continuously for 1200 h. Piperacillin-tazobactam, amoxicillin-clavulanic acid, cefuroxime, metronidazole and meropenem together accounted for over 84% of total emissions, with piperacillin-tazobactam alone contributing 97.5 kg CO₂e and 41.6 kg of waste from 62 prolonged prescriptions.

Conclusions: In addition to patient safety risks, prolonged IV antimicrobial courses generate considerable environmental waste. Aligning AMS with sustainability goals may contribute to addressing the dual crises of antimicrobial resistance and climate change.

Abstract Image

Abstract Image

po污染控制:在减少医疗保健的碳足迹抗菌管理的作用横断面研究。
目的:评估长时间静脉抗菌疗程对环境的影响,并确定改进抗菌药物管理(AMS)实践的机会。方法:对爱尔兰都柏林一家三级医院2023年1月至2024年12月的AMS查房数据进行回顾性横断面研究。回顾了静脉抗菌药物处方、AMS建议停药或静脉转口服(IVOS)和处方者接受度的数据。根据已发表的文献,采用生命周期评估来估计与静脉注射相关的碳足迹。结果:在审查的1929张抗菌药物处方中,有58% (n = 1119)为静脉给药处方。在435张采用AMS的静脉处方中,建议停用(n = 357)或IVOS (n = 78)的处方中,有229张(52.6%)被采纳,减少了106.5 kg的医疗废物和261.2 kg的二氧化碳当量(CO₂e)排放。其余206张(47.4%)静脉注射处方属于长期静脉注射处方,产生了98.8公斤的医疗废物和245.8公斤的二氧化碳;平均每份处方产生0.48公斤废物和1.19公斤二氧化碳。举例来说,每次延长处方的碳足迹相当于行驶6.2公里,进行10次胸部x光检查或连续使用10w发光二极管灯泡1200小时。哌拉西林-他唑巴坦、阿莫西林-克拉维酸、头孢呋辛、甲硝唑和美罗培南共占总排放量的84%以上,仅哌拉西林-他唑巴坦就产生了97.5公斤二氧化碳,62张长期处方产生了41.6公斤废物。结论:除了患者安全风险外,静脉注射抗菌药物疗程延长还会产生相当大的环境浪费。使AMS与可持续发展目标保持一致可能有助于解决抗菌素耐药性和气候变化的双重危机。
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
5.30
自引率
0.00%
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审稿时长
16 weeks
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