美罗培南短缺以及处方后审查和反馈对广谱抗菌药物使用的影响:间断时间序列分析

IF 1.8 Q3 INFECTIOUS DISEASES
Kohei Maruyama , Kiyoshi Sekiya , Noriyuki Yanagida , Shuhei Yasuda , Daisuke Fukumoto , Satoshi Hosoya , Hiromitsu Moriya , Motoko Kawabe , Tatsuya Mori
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引用次数: 0

摘要

背景美罗培南(MEPM)在治疗严重感染和耐药细菌方面具有重要意义。有人担心,抗菌药物短缺可能会导致人们使用疗效更差、安全性更低的替代抗菌药物。为应对 MEPM 短缺,我们采取了处方后监测和反馈(PPRF)措施,对 MEPM 的使用不加限制。我们旨在评估 MEPM 短缺和 PPRF 对广谱抗菌药物使用和死亡率的影响。2021 年 10 月至 2022 年 8 月期间被定义为 MEPM 短缺之前,2022 年 9 月至 2023 年 3 月期间被定义为 MEPM 短缺期间。为支持在 MEPM 短缺期间合理使用抗菌药物,抗菌药物管理小组 (AST) 制定了一份 MEPM 替代品清单。讨论MEPM和PPRF的短缺暂时增加了头孢吡肟替代品的使用;然而,随后治疗天数和广谱抗菌药物覆盖天数的变化表明这些抗菌药物的使用有所减少。尽管出现了这些变化,但死亡率仍保持稳定,这表明应对抗菌药物短缺的措施并未对治疗效果产生不利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of meropenem shortage and post-prescription review and feedback on broad-spectrum antimicrobial use: An interrupted time-series analysis

Background

Meropenem (MEPM) holds significance in treating severe infections and drug-resistant bacteria. There are concerns that antimicrobial shortages may lead to the use of alternative antimicrobials that are less effective and safer. We have responded to the MEPM shortage with post-prescription monitoring and feedback (PPRF) with no restrictions on MEPM initiation. We aimed to assess the impact of the MEPM shortage and the PPRF on broad-spectrum antimicrobial use and mortality.

Methods

This retrospective study was conducted in a single hospital in Japan. The period from October 2021 to August 2022 was defined as the period before the MEPM shortage, and the period from September 2022 to March 2023 was defined as the period during the MEPM shortage. To support the appropriate use of antimicrobials during MEPM shortages, the antimicrobial stewardship team (AST) developed a list of alternatives to MEPM. An interrupted time series analysis was used to assess changes in use and mortality among patients receiving broad-spectrum antimicrobials over the study period.

Discussion

The shortage of MEPM and PPRF temporarily increased the use of alternative cefepime; however, the subsequent change in days of therapy and days of coverage of broad-spectrum antimicrobials suggests a decrease in the use of these antimicrobials. Despite these shifts, the mortality rates remained stable, suggesting that the response to the shortage did not adversely affect treatment outcomes.

Conclusion

In the context of antimicrobial shortages, AST support plays an important role in enabling physicians to make optimal use of antimicrobials.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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