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Vol.38 No.6 contents | Japanese/English |
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Full Text of PDF (424K) Article in Japanese |
Effects on the Process and Outcome Indicators of the Carbapenem License System and the Full-time Pharmacist Following Meropenem Supply Disruption
Masahiro TAKADA1)2), Mika SHINGAI1), Ryuto MAEDA2), Hiroe YOSHINO3), Mayumi INADA4) and Takeshi SUDO1)5)
1)Division of Infection Control and Prevention, National Hospital Organization Kure Medical Center, 2)Division of Pharmacy, National Hospital Organization Kure Medical Center, 3)Department of Clinical Laboratory, National Hospital Organization Kure Medical Center, 4)Division of Nursing, National Hospital Organization Kure Medical Center, 5)Department of Surgery, National Hospital Organization Kure Medical Center
In late August 2022, the supply of meropenem (MEPM) from generic drug manufacturer T Corp. was discontinued. The National Hospital Organization Kure Medical Center introduced the carbapenem license system and a full-time antimicrobial stewardship team (AST) pharmacist to not only select alternatives to carbapenems but also ensure appropriate use of these drugs. This is a single-center cohort study of process and outcome measures, comparing the preintroduction from February 2022 to August 2022 and postintroduction from September 2022 to March 2023 in patients admitted to our hospital. The number of AST suggestions and consultations per 1000 admissions significantly increased from 1.3 and 0.5 to 3.1 and 1.6 (p < 0.05), respectively. Furthermore, the number of days of therapy (DOTs/1000 patient-days) with carbapenems and total antimicrobial agents with anti-Pseudomonas aeruginosa activity decreased significantly from 46.3±3.7 and 100.9±7.3 days to 10.1±6.7 and 85.4±9.0 days (p < 0.05), respectively. Furthermore, the 30-day mortality rate of patients with bacteremia did not change from 8.1% (17/209 patients) to 6.5% (15/232 patients). The resistance rate of P. aeruginosa was significantly decreased for MEPM (from 19.5% to 6.2%) and DRPM (from 14.9% to 2.5%) (p < 0.05). Thus, these results suggest that the discontinuation of MEPM supply provided an opportunity to promote the appropriate use of carbapenems.
Key words：meropenem, supply disruption, carbapenem license system, full-time pharmacist
e-mail: takada.masahiro.gu＠mail.hosp.go.jp
Received: May 29, 2023
Accepted: August 3, 2023
38 (6)：272─277,2023
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