Introducing an antibiotic stewardship program in a pediatric center in China

作     者：Zhi-Gang Zhang Fei Chen Jian-Zhong Chen 

作者机构：Department of PharmacologyLiaocheng People's Hospital of Shandong ProvinceLiaocheng 252000China 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2018年第14卷第3期

页      面：274-279页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Antimicrobial resistance Antibiotic stewardship program (ASP) Defined daily dose (DDD) Isolation of multidrug-resistant organisms (MDRO) 

摘      要：Background This study aimed to investigate the eff ect of antibiotic stewardship programs (ASP) on reducing antimicrobial resistance rate, antibiotics consumption and multi-drug resistance bacterial infections in the pediatric patients. Methods This study was carried out in the Pediatric Center of a tertiary hospital of Shandong Province, China. The study duration was separated into two periods according to introduction of ASP (began from April 2011). Before intervention: from April 2009 to March 2011;after intervention: from April 2012 to March 2014. The consumption of antibiotics, defi ned daily dose (DDD), isolation of multidrug-resistant organisms (MDRO) and resistance rate of antibiotics were analyzed and compared between the two study periods. Results Total antibiotics consumption (DDDs) reduced from 56,725 in 2011 to 31,380 in 2014;antibiotic use density (AUD) reduced from 93.8 to 43.5;mean (± SD) antibiotic costs per patient (per quarter) decreased from 637 (± 29) RMB to 462 (± 49) RMB;and the mean total drug consumption (g)/DDD (DDDs) for inpatients decreased from 90.4 (± 3.3) to 56.4 (± 9.5). Multidrug-resistant microorganisms isolation reduced signifi cantly from 463 (20.0) to 216 (6.9%). Resistance rate of general spectrum antibiotics reduced remarkably after intervention. The proportion of patients colonized or infected with Carbapenems-resistantAcinetobacter baumannii was correlated with DDDs of carbapenem. Conclusions Implementation of ASP leads to reduced medical expense, decrease of improper and abuse of antibiotics, and reduced antibiotics resistance rate and MDRO isolation. Continuous eff orts to improve antibiotic use are required.