ผลของการใช้แนวทางควบคุมกำกับดูแลยาปฏิชีวนะ Meropenem, Piperacillin/Tazobactam และ Vancomycin ภายในแผนกอายุรกรรม โรงพยาบาลสมเด็จพระเจ้าตากสินมหาราช

Abstract

Objective: To study the effects of antibiotic stewardship program by Meropenem, Piperacillin/ Tazobactam, Vancomycin restriction in medicine department, Somdejphrajao- taksinmaharaj Hospital.
Methods: The study was designed as Quasi-experimental study. Data collection was done in patients who were admitted in Medicine department, Somdejphrajaotaksinmaharaj Hospital during January to February 2019 and treated with Meropenem, Piperacillin/Tazobactam, Vancomycin for more than 2 days. Antibiotic stewardship program was implemented in February 2019. Pre and post restriction outcomes were compared in terms of procedural, clinical, and economical outcomes. Data analysis software was used to define p-value <0.05 as statistical significance.
Results: DDD/100 patients day of Meropenem and Piperacaillin/Tazobactam was decreased with %difference 25.41% and 16.53% respectively. Meanwhile, DDD/100 patients day of Vancomycin was increased 42.36%. In contrast with DDD/100 patients day of Vancomycin, overall antibiotics consumption rate was decreased by 24.50%. Appropriation of Meropenem, Piperacaillin/Tazobactam and Vancomycin utilization was improved 20.28, 3.24 and 5.00% respectively. Clinical outcomes were observed as rate of antimicrobial resistance in nosocomial infection and mortality rate which was decreased 4.2, 6.3% respectively. The decrement of hospitalization cost, antibiotics cost and admission duration was also observed in economical outcomes.
Conclusion: Antibiotic stewardship program could improve procedural, clinical, and economical outcomes.