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首页> 外文期刊>The Journal of Antimicrobial Chemotherapy >Specific control measures for antibiotic prescription are related to lower consumption in hospitals: results from a French multicentre pilot study.
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Specific control measures for antibiotic prescription are related to lower consumption in hospitals: results from a French multicentre pilot study.

机译：一项针对抗生素处方的特定控制措施与降低医院的消耗量有关：一项法国多中心试验研究的结果。

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BACKGROUND: In France, antibiotic consumption (ABC) is dramatically high in parallel with the high rate of multidrug-resistant bacteria. For the last few years, a nationwide policy has been implemented at the national level to control and monitor ABC. Since 2002, surveillance networks have been set up with voluntary hospitals to evaluate the antibiotic policy and consumption. The present study was conducted to identify whether specific control measures of the antibiotic policy could reduce ABC in hospitals. METHODS: Based on the data from the Northern France surveillance system, local recommendations and antibiotic use were collected annually on a standardized questionnaire that had 21 items. ABC was expressed in defined daily doses (DDDs) per 1000 patient-days (PDs). The ABC indicator was the overall antibiotic consumption. A multivariate logistic regression analysis was performed using low (< or =75th percentile) and high (>75th percentile) ABC as the dependent variable. RESULTS: A total of 83/111 hospitals were included in the study. In 75% of the hospitals, total ABC was < or =669.5 DDDs/1000 PDs. The less frequent practices were educational antibiotic programmes (17%), authorization from an antibiotic specialist for selected antibiotics (26%) and systematic reassessment of AB treatment after 72 h (27%). In the multivariate analysis, three variables remained significantly and independently associated (P < 0.05) with ABC: the type of hospital, the proportion of non-acute-care beds and the nominative delivery form as the only antibiotic control measure. Total ABC was lower in hospitals having a nominative delivery form, compared with hospitals not having it. Conversely, ABC was significantly higher in public teaching hospitals compared with non-teaching hospitals. Similarly, ABC was higher in hospitals with a lowest proportion (i.e. < or =25%) of non-acute-care beds compared with hospitals where this proportion was >25%. CONCLUSIONS: Specific control measures could lower ABC. Sustained control efforts should focus on antibiotics with the highest potential for emerging bacterial resistance.
机译：背景：在法国，抗生素消费量（ABC）很高，而耐多药细菌的发病率很高。在过去的几年中，已经在国家层面实施了一项全国性的政策来控制和监控ABC。自2002年以来，已经与志愿医院建立了监测网络，以评估抗生素政策和消费情况。本研究旨在确定抗生素政策的具体控制措施是否可以减少医院的ABC。方法：根据法国北部监测系统的数据，每年通过标准化问卷（21项）收集当地建议和抗生素使用情况。 ABC以每千个患者日（PDs）定义的每日剂量（DDD）表示。 ABC指标是总体抗生素消耗量。使用低（小于或等于第75个百分位数）和高（大于第75个百分位数）ABC作为因变量进行多元logistic回归分析。结果：共有83/111家医院被纳入研究。在75％的医院中，总ABC≤669.5 DDD / 1000 PD。较不频繁的做法是教育性抗生素计划（17％），抗生素专家对选定抗生素的授权（26％）和72小时后系统重新评估AB治疗（27％）。在多变量分析中，三个变量仍然与ABC显着且独立相关（P <0.05）：医院类型，非急性护理病床的比例和名义分娩形式是唯一的抗生素控制措施。具有指定分娩形式的医院的总ABC低于没有指定分娩形式的医院。相反，公立教学医院的ABC明显高于非教学医院。同样，非急性病床比例最低（即<或= 25％）的医院的ABC要高于该比例> 25％的医院。结论：特定的控制措施可以降低ABC。持续的控制努力应集中在具有最大潜力的新兴细菌耐药性的抗生素上。

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