全日制等效分配对抗菌药物管理活动有效性的影响：日本冈山的一项多中心研究。

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-05-13 DOI:10.1016/j.jiac.2025.102730

Shiho Kajita , Hideharu Hagiya , Atsushi Okita , Yuto Haruki , Haruto Yamada , Yasurou Inoue , Tsukasa Higashionna , Kana Satou , Fumihiro Torigoe , Shinobu Iwamoto , Mika Yoshida , Yumiko Yamane , Hiroki Kenmotsu , Satoru Sugimura , Yutaka Fujiwara , Fusao Ikeda , Toshihiro Koyama , Chikamasa Yoshida , Shinichirou Andou , Toshimitsu Suwaki

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引用次数: 0

摘要

背景：优化抗菌药物的管理是减轻抗菌药物耐药性出现的关键。本研究旨在阐明抗菌药物管理（AS）活动与抗菌药物处方趋势和模式之间的关系。方法：回顾性、多中心、纵向研究于2014年4月至2023年3月（9年财政期）进行。针对机构基础设施和环境参数、AS活动提供的服务方式、资源分配和系统支持以及使用广谱抗菌药物的数据，向在日本冈山市七家医院工作的联合调查人员分发了一项结构化问卷调查。计算了每个医疗机构的全职等效（FTE）分配，随后在医院之间进行了比较。采用联点回归分析对广谱抗菌药物比例分布的时间变化进行统计评价。结果：两家医院的药剂师专门从事AS活动，并满足推荐的FTE分配，广谱抗生素给药比例有统计学意义的减少，平均年百分比变化分别为-8.0%（95%置信区间[CI]: -10.5至-5.8）和-3.1% （95% CI: -5.5至-0.7）。相比之下，另外两家有全职AS成员但FTE分配不足的医院表现出不一致和统计上不一致的趋势。其余三家AS团队资源不足的医疗机构在广谱抗菌药物处方方面没有统计学上的显著趋势。结论：我们的研究结果表明，具有充分的AS活动FTE人员配置指标的医院在广谱抗菌药物的消费方面显示出统计上显著的下降趋势。

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Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan

Background

Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns.

Methods

This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis.

Results

Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions.

Conclusion

Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.