摘要
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。
Objective To explore the application effect of multi-disciplinary team(MDT)model in hospital antimicrobial 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 intervention 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 significant(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).Antimicrobial use rate in hospitalized patients and use rate of prophylactic antimicrobial agents in class I incision surgery decreased 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 decreased.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 antimicrobial agents in clinical practice,and prevent bacterial resistance.
作者
潘林丽
武大伟
刘善善
庞婕
邹秀珍
PAN Lin-li;WU Da-wei;LIU Shan-shan;PANG Jie;ZOU Xiu-zhen(Department of Infection Control,The First People’s Hospital of Lianyun-gang,Lianyungang 222002,China;Department of Pharmacy,The First People’s Hospital of Lianyun-gang,Lianyungang 222002,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2024年第6期719-724,共6页
Chinese Journal of Infection Control
基金
连云港市科协2023年度软课题研究项目(Lkxyb23121)。
