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多学科协作模式在医院抗菌药物管理中的应用

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目的 探索多学科协作(MDT)模式在医院抗菌药物管理中的应用效果。方法 采用回顾性分析方法收集某院2021年1月—2022年12月住院患者使用抗菌药物的相关资料,2021年1-12月采取常规管理模式(对照组),2022年1-12月采取MDT管理模式(干预组)。比较两组患者抗菌药物治疗相关指标。结果 采取MDT管理模式后,干预组治疗性抗菌药物使用前病原学送检率(73。62%)高于对照组(70。56%),差异有统计学意义(P<0。001)。医院感染诊断相关病原学送检率对照组为87。98%,干预组为88。89%,两组比较差异无统计学意义(P>0。05)。干预组重点药物联合使用前病原学送检率(93。94%)高于对照组(92。00%),差异有统计学意义(P<0。05)。住院患者抗菌药物使用率和Ⅰ类切口手术预防性抗菌药物使用率下降,分别由原来的38。03%、21。03%下降至32。78%、10。30%,差异均具有统计学意义(均P<0。05)。干预组住院患者的抗菌药物使用量和使用强度均下降。干预后多重耐药菌(MDRO)集束化防控措施落实率均较对照组提高,差异有统计学意义(均P<0。05)。MDRO检出率由34。70%下降至32。37%,差异有统计学意义(P=0。027),MDRO例次感染率无明显变化。结论 MDT管理模式可以有效提高抗菌药物的规范化管理,促进临床合理使用抗菌药物,防止细菌耐药。
Application of multi-disciplinary team model in the management of hospi-tal antimicrobial management
Objective To explore the application effect of multi-disciplinary team(MDT)model in hospital antimi-crobial management.Methods Relevant data on antimicrobial use in hospitalized patients in a hospital from January 2021 to December 2022 were analyzed retrospectively,January-December 2021 adopted conventional management mode and was as the control group,January-December 2022 adopted MDT management model and was as the inter-vention group.Antimicrobial therapy relevant indicators between two groups of patients were compared.Results After adopting the MDT management model,pathogen detection rate before the therapeutic antimicrobial use in the intervention group(73.62%)was higher than that in the control group(70.56%),difference was statistically sig-nificant(P<0.001).Pathogen detection rate related to healthcare-associated infection diagnosis was 87.98%in the control group and 88.89%in the intervention group,with no statistically significant difference between two groups(P>0.05).Pathogen detection rate before combined use of key antimicrobial agents in the intervention group(93.94%)was higher than that in the control group(92.00%),difference was statistically significant(P<0.05).Antimicro-bial use rate in hospitalized patients and use rate of prophylactic antimicrobial agents in class Ⅰ incision surgery de-creased from 38.03%and 21.03%to 32.78%and 10.30%,respectively,with statistically significant differences(both P<0.05).The amount and intensity of antimicrobial use in hospitalized patients in the intervention group de-creased.The implementation rate of bundled prevention and control measures for multidrug-resistant organism(MDRO)after intervention was significantly higher than that of the control group,with statistically significant differences(all P<0.05).MDRO detection rate decreased from 34.70%to 32.37%,difference was statistically significant(P=0.027).there was no significant change in the MDRO case infection rate.Conclusion The MDT model can effectively improve the standardized management of antimicrobial agents,promote the rational use of anti-microbial agents in clinical practice,and prevent bacterial resistance.

multi-disciplinary teamantimicrobial agentpathogen detection rateantimicrobial stewardshipMDTAMS

潘林丽、武大伟、刘善善、庞婕、邹秀珍

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连云港市第一人民医院感染管理科,江苏连云港 222002

连云港市第一人民医院药学部,江苏连云港 222002

多学科协作 抗菌药物 病原学送检率 抗菌药物科学化管理 MDT AMS

连云港市科协2023年度软课题研究项目

Lkxyb23121

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(6)