Đánh giá hiệu quả can thiệp của hoạt động dược lâm sàng trong việc sử dụng nhóm kháng sinh carbapenem tại khoa hồi sức tích cực - chống độc bệnh viện đa khoa tỉnh ninh thuận

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Tác giả: Ngọc Khôi Nguyễn, Như Hồ Nguyễn, Mạnh Duy Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 615 Pharmacology and therapeutics

Thông tin xuất bản: Tạp chí y học việt nam (tổng hội y học việt nam), 2022

Mô tả vật lý: 71-76

Bộ sưu tập: Metadata

ID: 489607

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Khảo sát tình hình đề kháng kháng sinh, tình hình sử dụng carbapenem và đánh giá bước đầu can thiệp của dược lâm sàng trong việc sử dụng carbapenem tại khoa Hồi sức tích cực - chống độc Bệnh viện đa khoa tỉnh Ninh Thuận. Đối tượng và phương pháp(:) Nghiên cứu cắt ngang, mô tả, so sánh hai giai đoạn gồm giai đoạn 1 (trước can thiệp) từ 07/2020 đến 12/2020 và giai đoạn 2 (can thiệp) từ 01/2021 đến 07/2021. Tính hợp lý của kháng sinh được đánh giá dựa vào Hướng dẫn sử dụng kháng sinh Bộ Y Tế 2015
Hướng dẫn sử dụng kháng sinh của bệnh viện đa khoa tỉnh Ninh Thuận 2017 và The Sanford Guide to Antimicrobial Therapy 2020. Kết quả(:) Ở cả hai giai đoạn, vi khuẩn Gram âm chiếm đa số và có tỷ lệ đề kháng carbapenem cao. Imipenem là kháng sinh trong nhóm carbapenem được chỉ định nhiều nhất. Với can thiệp của dược lâm sàng, tính hợp lý chung về sử dụng kháng sinh tăng lên 70,5%, tối ưu hóa về liều được chấp thuận chiếm 88,1% và tỷ lệ bệnh nhân khỏi bệnh chiếm 48,9%. Kết luận(:) Sau khi có sự can thiệp của dược sĩ lâm sàng, tính hợp lý trong việc sử dụng kháng sinh được cải thiện.To investigate the prevalence of antimicrobial resistance, the pattern of carbapenem use and to evaluate the initial intervention of clinical pharmacists on carbapenem use at the Intensive Care and Poison Control Department at Ninh Thuan Provincial General Hospital. Subjects and methods(:) A cross-sectional study was conducted, comparing two phases with phase 1 (pre-intervention phase) from 07/2020 to 12/2020 and phase 2 (intervention phase) from 01/2021 to 07/2021. Criteria for the critical use of antibiotics were based on Guidelines for using antibiotics of the Ministry of Health, 2015
Antibiotic Usage Guidelines of Ninh Thuan General Hospital, 2017 and The Sanford Guide to Antimicrobial Therapy, 2020. Results(:) In both phases, Gram-negative bacteria accounted for the majority of bacteria isolates and had a high rate of carbapenem resistance. Imipenems were more prevalent among carbapenems (over 90% of all medical records). With clinical pharmacist interventions, the appropriate use of antibiotics was increased to 70.5%
recommendations from pharmacists for dose optimization were approved in 88.1% of cases and 48.9% of patients recovered from the disease. Conclusion(:) After the intervention of a clinical pharmacist, the appropriateness of antibiotic use was improved. This shows the role of clinical pharmacists in the antimicrobial stewardship programs for antibiotics in general and carbapenems in particular.

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