薬剤耐性菌に対する126床市中病院における抗菌薬適正使用支援活動の方略と効果
「緒言」近年, 薬剤耐性(antimicrobial resistance: AMR)は環境や人の健康に影響を及ぼす世界的な公衆衛生上の最大の課題の1つとなっている(World Health Organization. 2020 Antibiotic resistance; 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance, 2023年9月8日). 医療機関においては, AMRによる感染症により, 入院期間の長期化や病院コストの増大, 死亡率の上昇を招いている...
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| Published in | 医療薬学 Vol. 50; no. 3; pp. 113 - 121 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
10.03.2024
日本医療薬学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.50.113 |
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| Abstract | 「緒言」近年, 薬剤耐性(antimicrobial resistance: AMR)は環境や人の健康に影響を及ぼす世界的な公衆衛生上の最大の課題の1つとなっている(World Health Organization. 2020 Antibiotic resistance; 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance, 2023年9月8日). 医療機関においては, AMRによる感染症により, 入院期間の長期化や病院コストの増大, 死亡率の上昇を招いている. 2016年には米国感染症学会/米国病院疫学学会による抗菌薬管理ガイドラインにおいて, 不適切な抗菌薬の使用を減らし, 抗菌薬の副作用, 菌交代現象, 薬剤耐性菌の出現など抗菌薬使用による意図しない結果を最小限に抑えながら臨床転帰を最適化すること, さらには医療の質に悪影響を与えることなく医療費を削減することを目標とした抗菌薬適正使用支援プログラム(antimicrobial stewardship program: ASP)が提唱された. |
|---|---|
| AbstractList | 「緒言」近年, 薬剤耐性(antimicrobial resistance: AMR)は環境や人の健康に影響を及ぼす世界的な公衆衛生上の最大の課題の1つとなっている(World Health Organization. 2020 Antibiotic resistance; 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance, 2023年9月8日). 医療機関においては, AMRによる感染症により, 入院期間の長期化や病院コストの増大, 死亡率の上昇を招いている. 2016年には米国感染症学会/米国病院疫学学会による抗菌薬管理ガイドラインにおいて, 不適切な抗菌薬の使用を減らし, 抗菌薬の副作用, 菌交代現象, 薬剤耐性菌の出現など抗菌薬使用による意図しない結果を最小限に抑えながら臨床転帰を最適化すること, さらには医療の質に悪影響を与えることなく医療費を削減することを目標とした抗菌薬適正使用支援プログラム(antimicrobial stewardship program: ASP)が提唱された. |
| Author | 中島, 隆司 藤﨑, 崇史 本屋, 敏郎 桑波田, 聡 愛甲, 隼人 東, 勇希 中村, 聡志 有馬, 隆司 安水, 里美 竹中, 俊宏 黒木, 優歩 田代, 良一 |
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| DOI | 10.5649/jjphcs.50.113 |
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| References | 10）Mas-Morey P, Valle M, A systematic review of inpatient antimicrobial stewardship programmes involving clinical pharmacists in small-to-mediumsized hospitals, Eur J Hosp Pharm, 2018, 25, e69-e73. doi: 10.1136/ejhpharm-2017-001381. 20）Anderson DJ, Watson S, Moehring RW, Komarow L, Finnemeyer M, Arias RM, Huvane J, Hill CB, Deckard N, Sexton DJ, Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals, JAMA Netw Open, 2019, 2, e199369. doi: 10.1001/jamanetworkopen.2019.9369. 9）Tsugita M, Antimicrobial Susceptibility of Pseudomonas aeruginosa Is Improved by Pharmacist’s Intervention in the Use of Antimicrobial Agents, Jpn J Environment Infect, 2012, 27, 285-291. 19）Bantar C, Sartori B, Vesco E, Heft C, Saúl M, Salamone F, Oliva ME, A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance, Clin Infect Dis, 2003, 37, 180-186. 11）Takito S, Kusama Y, Fukuda H, Kutsuna S, Pharmacist-supported antimicrobial stewardship in a retirement home, J Infect Chemother, 2020, 26, 858-861. 6）Akazawa T, Kusama Y, Fukuda H, Hayakawa K, Kutsuna S, Moriyama Y, Ohashi H, Tamura S, Yamamoto K, Hara R, Shigeno A, Ota M, Ishikane M, Tokita S, Terakado H, Ohmagari N, Eight-Year Experience of Antimicrobial Stewardship Program and the Trend of Carbapenem Use at a Tertiary Acute-Care Hospital in Japan—The Impact of Postprescription Review and Feedback, Open Forum Infect Dis, 2019, 6, ofz389. doi: 10.1093/ofid/ofz389. 13）Aldred KJ, Kerns RJ, Osheroff N, Mechanism of quinolone action and resistance, Biochemistry, 2014, 53, 1565-1574. 15）Uda A, Shigemura K, Kitagawa K, Osawa K, Kusuki M, Yan Y, Yano I, Miyara T, Effect of Antimicrobial Stewardship on Oral Quinolone Use and Resistance Patterns over 8 Years (2013–2020), Antibiotics (Basel), 2021, 10, 1426. doi: 10.3390/antibiotics10111426. 4）Yamada K, Imoto W, Yamairi K, Shibata W, Namikawa H, Yoshii N, Fujimoto H, Nakaie K, Okada Y, Fujita A, Kawaguchi H, Shinoda Y, Nakamura Y, Kaneko Y, Yoshida H, Kakeya H, The intervention by an antimicrobial stewardship team can improve clinical and microbiological outcomes of resistant gram-negative bacteria, J Infect Chemother, 2019, 25, 1001-1006. 8）Maeda M, Muraki Y, Kosaka T, Yamada T, Aoki Y, Kaku M, Kawaguchi T, Seki M, Tanabe Y, Fujita N, Morita K, Yanagihara K, Yoshida K, Niki Y, The first nationwide survey of antimicrobial stewardship programs conducted by the Japanese Society of Chemotherapy, J Infect Chemother, 2019, 25, 83-88. 2）Roberts RR, Hota B, Ahmad I, Scott RD II, Foster SD, Abbasi F, Schabowski S, Kampe LM, Ciavarella GG, Supino M, Naples J, Cordell R, Levy SB, Weinstein RA, Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship, Clin Infect Dis, 2009, 49, 1175-1184. 21）村木優一, 抗菌薬適正使用支援における薬剤師の役割, YAKUGAKU ZASSHI, 2019, 139, 557-564. 12）Nakamura S, Arima T, Tashiro R, Yasumizu S, Aikou H, Watanabe E, Nakashima T, Nagatomo Y, Kakimoto I, Motoya T, Impact of an antimicrobial stewardship in a 126-bed community hospital with close communication between pharmacists working on post-prescription audit, ward pharmacists, and the antimicrobial stewardship team, J Pharm Health Care Sci, 2021, 7, 25. doi: 10.1186/s40780-021-00206-x. 3）Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, Srinivasan A, Dellit TH, Falck-Ytter YT, Fishman NO, Hamilton CW, Jenkins TC, Lipsett PA, Malani PN, May LS, Moran GJ, Neuhauser MM, Newland JG, Ohl CA, Samore MH, Seo SK, Trivedi KK, Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America, Clin Infect Dis, 2016, 62, e51-77. doi: 10.1093/cid/ciw118. 1）Giske CG, Monnet DL, Cars O, Carmeli Y, Clinical and Economic Impact of Common Multidrug-Resistant Gram-Negative Bacilli, Antimicrob Agents Chemother, 2008, 52, 813-821. 18）村田明子, 川嶋 郁, 畠山英司, 山﨑彩華, 松本勝城, 深沢貴志, 松本菜月, 神谷あかね, 藤田浩之, 擦式アルコール手指消毒薬の使用率向上による細菌分離率の低下, 日本環境感染学会誌, 2020, 35, 163-167. 14）Terahara F, Nishiura H, Fluoroquinolone consumption and Escherichia coli resistance in Japan: an ecological study, BMC Public Health, 2019, 19, 426. doi: 10.1186/s12889-019-6804-3. 17）中村茂樹, MRSAの感染制御, 日本環境感染学会誌, 2022, 37, 217-226. 22）Doernberg SB, Dudas V, Trivedi KK, Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis, Antimicrob Resist Infect Control, 2015, 4, 54. doi: 10.1186/s13756-015-0095-y. 16）Wang H, Wang H, Yu X, Zhou H, Li B, Chen G, Ye Z, Wang Y, Cui X, Zheng Y, Zhao R, Yang H, Wang Z, Wang P, Yang C, Liu L, Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010–2016: a retrospective observational study, BMJ Open, 2019, 9, e026072. doi: 10.1136/bmjopen-2018-026072. 7）Maeda M, Muraki Y, Kosaka T, Yamada T, Aoki Y, Kaku M, Seki M, Tanabe Y, Fujita N, Niki Y, Morita K, Yanagihara K, Yoshida K, Kawaguchi T, Impact of health policy on structural requisites for antimicrobial stewardship: A nationwide survey conducted in Japanese hospitals after enforcing the revised reimbursement system for antimicrobial stewardship programs, J Infect Chemother, 2021, 27, 1-6. 5）Hagiwara D, Sato K, Miyazaki M, Kamada M, Moriwaki N, Nakano T, Shiotsuka S, Tokushige C, Toh H, Kamimura H, Togawa A, Takata T, The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single weekly intervention, Int J Infect Dis, 2018, 77, 34-39. |
| References_xml | – reference: 16）Wang H, Wang H, Yu X, Zhou H, Li B, Chen G, Ye Z, Wang Y, Cui X, Zheng Y, Zhao R, Yang H, Wang Z, Wang P, Yang C, Liu L, Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010–2016: a retrospective observational study, BMJ Open, 2019, 9, e026072. doi: 10.1136/bmjopen-2018-026072. – reference: 8）Maeda M, Muraki Y, Kosaka T, Yamada T, Aoki Y, Kaku M, Kawaguchi T, Seki M, Tanabe Y, Fujita N, Morita K, Yanagihara K, Yoshida K, Niki Y, The first nationwide survey of antimicrobial stewardship programs conducted by the Japanese Society of Chemotherapy, J Infect Chemother, 2019, 25, 83-88. – reference: 7）Maeda M, Muraki Y, Kosaka T, Yamada T, Aoki Y, Kaku M, Seki M, Tanabe Y, Fujita N, Niki Y, Morita K, Yanagihara K, Yoshida K, Kawaguchi T, Impact of health policy on structural requisites for antimicrobial stewardship: A nationwide survey conducted in Japanese hospitals after enforcing the revised reimbursement system for antimicrobial stewardship programs, J Infect Chemother, 2021, 27, 1-6. – reference: 2）Roberts RR, Hota B, Ahmad I, Scott RD II, Foster SD, Abbasi F, Schabowski S, Kampe LM, Ciavarella GG, Supino M, Naples J, Cordell R, Levy SB, Weinstein RA, Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship, Clin Infect Dis, 2009, 49, 1175-1184. – reference: 12）Nakamura S, Arima T, Tashiro R, Yasumizu S, Aikou H, Watanabe E, Nakashima T, Nagatomo Y, Kakimoto I, Motoya T, Impact of an antimicrobial stewardship in a 126-bed community hospital with close communication between pharmacists working on post-prescription audit, ward pharmacists, and the antimicrobial stewardship team, J Pharm Health Care Sci, 2021, 7, 25. doi: 10.1186/s40780-021-00206-x. – reference: 3）Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, Srinivasan A, Dellit TH, Falck-Ytter YT, Fishman NO, Hamilton CW, Jenkins TC, Lipsett PA, Malani PN, May LS, Moran GJ, Neuhauser MM, Newland JG, Ohl CA, Samore MH, Seo SK, Trivedi KK, Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America, Clin Infect Dis, 2016, 62, e51-77. doi: 10.1093/cid/ciw118. – reference: 15）Uda A, Shigemura K, Kitagawa K, Osawa K, Kusuki M, Yan Y, Yano I, Miyara T, Effect of Antimicrobial Stewardship on Oral Quinolone Use and Resistance Patterns over 8 Years (2013–2020), Antibiotics (Basel), 2021, 10, 1426. doi: 10.3390/antibiotics10111426. – reference: 17）中村茂樹, MRSAの感染制御, 日本環境感染学会誌, 2022, 37, 217-226. – reference: 1）Giske CG, Monnet DL, Cars O, Carmeli Y, Clinical and Economic Impact of Common Multidrug-Resistant Gram-Negative Bacilli, Antimicrob Agents Chemother, 2008, 52, 813-821. – reference: 11）Takito S, Kusama Y, Fukuda H, Kutsuna S, Pharmacist-supported antimicrobial stewardship in a retirement home, J Infect Chemother, 2020, 26, 858-861. – reference: 20）Anderson DJ, Watson S, Moehring RW, Komarow L, Finnemeyer M, Arias RM, Huvane J, Hill CB, Deckard N, Sexton DJ, Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals, JAMA Netw Open, 2019, 2, e199369. doi: 10.1001/jamanetworkopen.2019.9369. – reference: 6）Akazawa T, Kusama Y, Fukuda H, Hayakawa K, Kutsuna S, Moriyama Y, Ohashi H, Tamura S, Yamamoto K, Hara R, Shigeno A, Ota M, Ishikane M, Tokita S, Terakado H, Ohmagari N, Eight-Year Experience of Antimicrobial Stewardship Program and the Trend of Carbapenem Use at a Tertiary Acute-Care Hospital in Japan—The Impact of Postprescription Review and Feedback, Open Forum Infect Dis, 2019, 6, ofz389. doi: 10.1093/ofid/ofz389. – reference: 4）Yamada K, Imoto W, Yamairi K, Shibata W, Namikawa H, Yoshii N, Fujimoto H, Nakaie K, Okada Y, Fujita A, Kawaguchi H, Shinoda Y, Nakamura Y, Kaneko Y, Yoshida H, Kakeya H, The intervention by an antimicrobial stewardship team can improve clinical and microbiological outcomes of resistant gram-negative bacteria, J Infect Chemother, 2019, 25, 1001-1006. – reference: 5）Hagiwara D, Sato K, Miyazaki M, Kamada M, Moriwaki N, Nakano T, Shiotsuka S, Tokushige C, Toh H, Kamimura H, Togawa A, Takata T, The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single weekly intervention, Int J Infect Dis, 2018, 77, 34-39. – reference: 9）Tsugita M, Antimicrobial Susceptibility of Pseudomonas aeruginosa Is Improved by Pharmacist’s Intervention in the Use of Antimicrobial Agents, Jpn J Environment Infect, 2012, 27, 285-291. – reference: 14）Terahara F, Nishiura H, Fluoroquinolone consumption and Escherichia coli resistance in Japan: an ecological study, BMC Public Health, 2019, 19, 426. doi: 10.1186/s12889-019-6804-3. – reference: 21）村木優一, 抗菌薬適正使用支援における薬剤師の役割, YAKUGAKU ZASSHI, 2019, 139, 557-564. – reference: 18）村田明子, 川嶋 郁, 畠山英司, 山﨑彩華, 松本勝城, 深沢貴志, 松本菜月, 神谷あかね, 藤田浩之, 擦式アルコール手指消毒薬の使用率向上による細菌分離率の低下, 日本環境感染学会誌, 2020, 35, 163-167. – reference: 19）Bantar C, Sartori B, Vesco E, Heft C, Saúl M, Salamone F, Oliva ME, A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance, Clin Infect Dis, 2003, 37, 180-186. – reference: 10）Mas-Morey P, Valle M, A systematic review of inpatient antimicrobial stewardship programmes involving clinical pharmacists in small-to-mediumsized hospitals, Eur J Hosp Pharm, 2018, 25, e69-e73. doi: 10.1136/ejhpharm-2017-001381. – reference: 13）Aldred KJ, Kerns RJ, Osheroff N, Mechanism of quinolone action and resistance, Biochemistry, 2014, 53, 1565-1574. – reference: 22）Doernberg SB, Dudas V, Trivedi KK, Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis, Antimicrob Resist Infect Control, 2015, 4, 54. doi: 10.1186/s13756-015-0095-y. |
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| Title | 薬剤耐性菌に対する126床市中病院における抗菌薬適正使用支援活動の方略と効果 |
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| ispartofPNX | 医療薬学, 2024/03/10, Vol.50(3), pp.113-121 |
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