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Vol.38 No.4 contents | Japanese/English |
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Full Text of PDF (742K) Article in Japanese |
Investigation of the Association between the Proportion of Appropriate Execution of Antimicrobial Use Processes and Accurate and Reliable Entry of Notification Forms for Antimicrobial Use Installed in an Electric Medical Record System under the Support of the Antimicrobial Stewardship Team
Takehiro TANAKA1), Ryo YAMAGUCHI1), Takehito YAMAMOTO1)2), Keita TATSUNO3)4), Koh OKAMOTO4), Sohei HARADA3), Kyoji MORIYA3)4) and Tappei TAKADA1)
1)Department of Pharmacy, The University of Tokyo Hospital, 2)The Education Center for Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 3)Department of Infection Control and Prevention, The University of Tokyo Hospital, 4)Department of Infectious Diseases, The University of Tokyo Hospital
The impact of the appropriate entry of the antimicrobial use notification form on the proportion of appropriate execution of the antimicrobial use process (process execution rate) is still unclear. In this study, we aimed to examine whether accurate and reliable entry of notification forms for antimicrobial use associate to improve the process execution rate.
In patients who received anti-MRSA or carbapenem antimicrobial agents from January 1 to December 31, 2018, at The University of Tokyo Hospital were included in this retrospective, observational study. Of the five items required to be entered in the notification forms for anti-MRSA and carbapenem antimicrobial agents use (dosage, expected duration of use, suspected site of infection, planned date of therapeutic drug monitoring [only for anti-MRSA agents], whether cultures of suspected infection site were collected [only for carbapenem antimicrobial agents], and whether blood cultures were collected), patients with ≥4 items entered were classified as the good-compliance group, whereas those with ≥3 items entered were in the poor-compliance group. The process execution rates by the attending physician for the five items were compared between the two groups.
A total of 399 patients were included: 145 in the anti-MRSA group (89 in the good-compliance group and 56 in the poor-compliance group) and 254 in the carbapenem antimicrobial agents group (178 in the good-compliance group and 76 in the poor-compliance group). No significant differences were observed in process execution rates between the good-compliance and poor-compliance groups in any of the five items for both the anti-MRSA agent group and the carbapenem antimicrobial agent group.
These observations suggest that, in facilities with the support of the Antimicrobial Stewardship Team, the impact of compliance with an entry on notification forms installed in an electric medical record system on the processes execution rates of appropriate antimicrobial use is limited and that there remains room for reconsideration of the items on the notification forms depending on the characteristics of the facility.
Key words：antimicrobial stewardship program, notification forms for antimicrobial use, prospective audit and feedback, anti-MRSA agent, carbapenem antibiotics
e-mail: ttanaka-pha＠g.ecc.u-tokyo.ac.jp
Received: September 29, 2022
Accepted: March 22, 2023
38 (4)：181─191,2023
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