Improved Clinical Outcomes in Patients with Positive Blood Culture by Proactive Intervention of Antimicrobial Use —Impact of Antimicrobial Stewardship Program Implementation on Clinical Practice
| Autor: | Takehiro, Yamada, Keisuke, Kagami, Shungo, Imai, Koji, Akizawa, Sumio, Iwasaki, Tatsuya, Fukumoto, Nobuhisa, Ishiguro, Ken, Iseki |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Adolescent 030106 microbiology Pharmacist Pharmaceutical Science Bacteremia Pharmacists Young Adult 03 medical and health sciences 0302 clinical medicine Physicians Antimicrobial chemotherapy Humans Medicine Antimicrobial stewardship Infection control 030212 general & internal medicine Medical prescription Child Intensive care medicine Aged Retrospective Studies Aged 80 and over Patient Care Team Pharmacology Cross Infection Infection Control Infection Control Practitioners business.industry Infant Middle Aged Antimicrobial medicine.disease Anti-Bacterial Agents Treatment Outcome Blood Culture Child Preschool Practice Guidelines as Topic Female business |
| Zdroj: | YAKUGAKU ZASSHI. 137:917-925 |
| ISSN: | 1347-5231 0031-6903 |
| DOI: | 10.1248/yakushi.17-00037 |
| Popis: | Bacteremia is one of the most serious infectious illness resulting from nosocomial infection. Therefore, appropriate antimicrobial chemotherapy should be provided as soon as possible to patients exhibiting symptoms of infectious disease and having positive blood culture results. Antimicrobial stewardship (AS) guidelines were recently released by the Infectious Diseases Society of America. The guidelines recommend "proactive intervention and feedback" as one of the core strategies for implementing optimal antimicrobial drug use to improve patient outcomes in clinical settings. We began using the AS program for optimizing antimicrobial chemotherapy in patients with positive blood culture results. The results of blood cultures and antimicrobial prescriptions for the corresponding patients were daily reviewed by a pharmacist and a physician, members of the infection control team (ICT). If the antimicrobial agents selected were inappropriate, ICT made a recommendation to the attending physicians who prescribed the antibiotics. To evaluate the outcomes of this program, we conducted a single-center, retrospective investigation for near a hundred of patients who underwent intervention by infection-control physician and pharmacist. Resolution of bacteremia (determined by blood culture results) was 96.3% in the group that accepted intervention, whereas only 16.7% of the cases resolved in the group that did not accept intervention. These results strongly suggest the importance of the infection disease-specialist team intervention. This program could become an important method for improving clinical outcomes in patients with bacteremia. |
| Databáze: | OpenAIRE |
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