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�й�ҩѧ��־ 2014, Vol. 49 Issue (23) :2136-2140    DOI: 10.11669/cpj.2014.23.018
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ZHANG Boa, HU Yanga, ZHAO Jinga, ZHANG Qiana, WANG De-zhia, MA Lianb, SUN Hong-lic, ZHANG Zhan-jied, MEI Dana
a.Department of Pharmacy; b.Department of Clinical Laboratory; c.Information Center; d. Department of Medical Service Supervise, Peking Union Medical College Hospital, Peking Union Medical College-Chinese Academy of Medical Science, Beijing 100730, China

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ժҪ Ŀ�� �˽⿹��ҩ��ר�����λǰ����Ժ����ҩ��ʹ�ú�ϸ����ҩ�Ա仯���ơ����� ��������ǰ����շ���,����Ժ����ҩ��ר������ǰ(2010��)�����κ�(2011~2013��)����ҩ��ʹ�������ϸ����ҩ�Խ��з�������� ��2010�����,2011~2013�꿹��ҩ��ר�����λ�ڼ���Ժ�������������λ����������ֱ�����20.8%��21.4%,��ȫԺ����ҩ��ɹ���סԺ���߿���ҩ��ʹ������סԺ���߿���ҩ��ʹ��ǿ�ȡ�סԺ���߿���ҩ��ʹ���ʺ����ﻼ�߿���ҩ�ﴦ�������ֱ��½�2.6%(262.23��Ԫ)��16.4%(46 985.91DDDs)��31.1%(17.88DDD/100��)��17.3%(64.1% vs 46.8%)��25.2%(2.1%);����ǰ����Ժ����ҩ��ʹ�����෢���仯,2011~2013��һ��ͷ�ߡ�����ͷ�ߡ�����ͷ�ߡ����������ࡢ������������������6�࿹��ҩ��ɹ������½�����,�ֱ��½�36.0%��20.2%��10.7%��8.1%��7.0%��2.0%;����ҩ��ɹ������ӷ��Ƚϴ�İ�����������(198.0%)��dz�������(103.7%)���ǰ���(60.8%)���Ļ�����(39.0%)���ֿ�ù����(38.4%)��̼��ùϩ��(37.5%)���Ĵ�ͷ��(33.8%);��2010�����,2013��ȫԺ����������ҩ���ɫ�������(MRSA)����ESBL�󳦰�ϣ���Ͳ�ESBL���׿��ײ����ļ�����½�����,�ֱ𽵵�13.8%(43.4% vs 29.6% )��6%(56.2% vs 50.2%)��5.6%(30.4% vs 24.8%),������ҩ��ҩ���ļ���ʺ�2010����ȱ仯���󡣽��� 3��ȫ������ҩ��ר�����λ����Ժȡ����������Ч,����ҩ���ʹ�ú�ϸ������ҩ�Եõ��˽ϺõĿ���,Ӧ��һ��������⿹��ҩ��ʹ�ú�ϸ����ҩ�ԡ�
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Abstract�� OBJECTIVE To investigate the prescribing pattern and the antimicrobial resistance of clinical isolates before and after implementation of a 3-year national antimicrobial stewardship program. METHODS This was a before- and-after controlled study, which was carried out in a 2000 beds tertiary comprehensive hospital. The intervention was a 3-year national antimicrobial stewardship program (ASP) from 2011-2013 year. Antibiotic consumption and antimicrobial resistance from 2010 to 2013 year were analyzed. RESULTS Compared with 2010 year, outpatient visits and inpatient days in 2011-2013 increased by 20.8% and 21.4%, but cost of antimicrobial purchasing ,antimicrobial consumption quantities by inpatients (DDD per 100 occupied bed-days) , percent of inpatients who received antimicrobial during hospitalization and the ratio of outpatients who received antimicrobial prescription decreased by 2.6%, 31.1 % ,17.3% and 5.2%. After the 3-year national ASP, antimicrobial purchasing quantities (2011-2013) of the 1st generation cephalosporin, 2nd generation cephalosporin, 3rd generation cephalosporin, nitroimidazole, aminoglycosides and glycopeptides in our hospital decreased by 36.0%, 20.2%, 10.7%, 8.1%, 7.0% and 2.0% compared with 2010. Antimicrobials whose purchasing quantities increased after ASP (2011-2013) were chloramphenicol(198.0%),superficial antifungal (103.7%), sulfonamides(60.8%),tetracyclines (39.0%), clindamycin (38.4%), carbapenems (37.5%) and 4th generation cephalosporin(33.8%). Compared with 2010, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) , ESBLs-positive in the strains of E.coli and ESBLs-positive in the strains of Klebsiella pneumoniae decreased by 13.8%(43.4% vs 29.6% ),6%(56.2% vs 50.2%)and 5.6%(30.4% vs 24.8%).The other multi-drug resistant organisms incidence was similar with 2010 year. CONCLUSION The 3-year national antimicrobial stewardship program is associated with reductions in antimicrobial use and multi-drug resistant organism incidence in our hospital. Continuing surveillance should be done.
Keywords�� antimicrobial stewardship program,   antimicrobial,   antimicrobial resistance     
�ո�����: 2014-12-31;
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�Ų�a, ����a, �Ծ�a�� .3�꿹��ҩ��ר�����λǰ����Ժ����ҩ��ʹ�ú�ϸ����ҩ�Ա仯����[J]  �й�ҩѧ��־, 2014,V49(23): 2136-2140
ZHANG Bo-a, HU Yang-a, ZHAO Jing-a etc .Antimicrobial Utilization and Antimicrobial Resistance Trend before and after Implementation of a 3-Year National Antimicrobial Stewardship Program in a Tertiary Hospital[J]  Chinese Pharmaceutical Journal, 2014,V49(23): 2136-2140
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