PDF(Pubmed)
Abstract：
UNASSIGNED: Meropenem (MEPM) holds significance in treating severe infections and drug-resistant bacteria. There are concerns that antimicrobial shortages may lead to the use of alternative antimicrobials that are less effective and safer. We have responded to the MEPM shortage with post-prescription monitoring and feedback (PPRF) with no restrictions on MEPM initiation. We aimed to assess the impact of the MEPM shortage and the PPRF on broad-spectrum antimicrobial use and mortality.
UNASSIGNED: This retrospective study was conducted in a single hospital in Japan. The period from October 2021 to August 2022 was defined as the period before the MEPM shortage, and the period from September 2022 to March 2023 was defined as the period during the MEPM shortage. To support the appropriate use of antimicrobials during MEPM shortages, the antimicrobial stewardship team (AST) developed a list of alternatives to MEPM. An interrupted time series analysis was used to assess changes in use and mortality among patients receiving broad-spectrum antimicrobials over the study period.
UNASSIGNED: The shortage of MEPM and PPRF temporarily increased the use of alternative cefepime; however, the subsequent change in days of therapy and days of coverage of broad-spectrum antimicrobials suggests a decrease in the use of these antimicrobials. Despite these shifts, the mortality rates remained stable, suggesting that the response to the shortage did not adversely affect treatment outcomes.
UNASSIGNED: In the context of antimicrobial shortages, AST support plays an important role in enabling physicians to make optimal use of antimicrobials.
UNASSIGNED: This retrospective study was conducted in a single hospital in Japan. The period from October 2021 to August 2022 was defined as the period before the MEPM shortage, and the period from September 2022 to March 2023 was defined as the period during the MEPM shortage. To support the appropriate use of antimicrobials during MEPM shortages, the antimicrobial stewardship team (AST) developed a list of alternatives to MEPM. An interrupted time series analysis was used to assess changes in use and mortality among patients receiving broad-spectrum antimicrobials over the study period.
UNASSIGNED: The shortage of MEPM and PPRF temporarily increased the use of alternative cefepime; however, the subsequent change in days of therapy and days of coverage of broad-spectrum antimicrobials suggests a decrease in the use of these antimicrobials. Despite these shifts, the mortality rates remained stable, suggesting that the response to the shortage did not adversely affect treatment outcomes.
UNASSIGNED: In the context of antimicrobial shortages, AST support plays an important role in enabling physicians to make optimal use of antimicrobials.
摘要：
■美罗培南（MEPM）在治疗严重感染和耐药细菌方面具有重要意义。有人担心，抗菌药物短缺可能导致使用无效和更安全的替代抗菌药物。我们通过处方后监测和反馈（PPRF）来应对MEPM短缺，对MEPM的启动没有任何限制。我们旨在评估MEPM短缺和PPRF对广谱抗菌药物使用和死亡率的影响。
■这项回顾性研究是在日本的一家医院进行的。2021年10月至2022年8月被定义为MEPM短缺之前的时期，2022年9月至2023年3月被定义为MEPM短缺期间。为了在MEPM短缺期间支持适当使用抗菌药物，抗菌药物管理团队(AST)制定了MEPM替代方案清单.中断时间序列分析用于评估在研究期间接受广谱抗微生物药物的患者的使用和死亡率的变化。
■MEPM和PPRF的短缺暂时增加了替代头孢吡肟的使用；然而，随后治疗天数和广谱抗菌药物覆盖天数的变化表明这些抗菌药物的使用减少.尽管有这些转变,死亡率保持稳定，提示对短缺的反应并未对治疗结局产生不利影响.
■在抗菌药物短缺的背景下，AST支持在使医生能够最佳地使用抗菌药物方面起着重要作用。
■这项回顾性研究是在日本的一家医院进行的。2021年10月至2022年8月被定义为MEPM短缺之前的时期，2022年9月至2023年3月被定义为MEPM短缺期间。为了在MEPM短缺期间支持适当使用抗菌药物，抗菌药物管理团队(AST)制定了MEPM替代方案清单.中断时间序列分析用于评估在研究期间接受广谱抗微生物药物的患者的使用和死亡率的变化。
■MEPM和PPRF的短缺暂时增加了替代头孢吡肟的使用；然而，随后治疗天数和广谱抗菌药物覆盖天数的变化表明这些抗菌药物的使用减少.尽管有这些转变,死亡率保持稳定，提示对短缺的反应并未对治疗结局产生不利影响.
■在抗菌药物短缺的背景下，AST支持在使医生能够最佳地使用抗菌药物方面起着重要作用。
