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- 田井 達也
- 香川大学医学部附属病院薬剤部 香川大学医学部附属病院感染制御部
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- 山口 佳津騎
- 香川大学医学部附属病院薬剤部 香川大学医学部附属病院感染制御部
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- 渡邊 政博
- 就実大学薬学部生体情報学
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- 井上 達也
- 香川大学医学部附属病院薬剤部
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- 元木 貴大
- 香川大学医学部附属病院薬剤部
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- 田中 裕章
- 香川大学医学部附属病院薬剤部
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- 間嶋 由美子
- 香川大学医学部附属病院感染制御部 香川大学医学部附属病院看護部
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- 根ヶ山 清
- 香川大学医学部附属病院感染制御部 香川大学医学部附属病院検査部
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- 横田 恭子
- 香川大学医学部附属病院感染制御部 香川県立中央病院感染症科
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- 加地 雅人
- 香川大学医学部附属病院薬剤部
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- 小坂 信二
- 香川大学医学部附属病院薬剤部
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- 芳地 一
- 香川大学医学部附属病院薬剤部
書誌事項
- タイトル別名
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- Effect of De-escalation Facilitated by Antimicrobial Stewardship Activities on Blood Culture Positive Patient Outcomes
この論文をさがす
説明
<p>To evaluate changes in the efficacy and safety of antimicrobial therapy through de-escalation improved by the antimicrobial stewardship (AS) activities, which started from 2013 in Kagawa University Hospital, we analyzed changes in the de-escalation rate and the patient outcomes. The number of carbapenem-treated cases evaluated as ‘improper use’ had decreased from 2013 to 2017. In most of these cases, improper use of blood culture was indicated. The AS team directed the proper use of carbapenem through weekly rounds, focusing on “intervention and feedback” according to the guideline. This activity was performed with emphasis on the appropriate use of blood culture results and the process of target therapy. As a result, it was shown that the number of blood culture orders and the rates of hospitalized cases, for which multiple sets of blood cultures were ordered, were increased. Also, the de-escalation rate of blood culture-positive cases treated with carbapenem was improved from 13.1％ in 2011 to 29.9％ in 2017. Furthermore, as a patient outcome, the 90-day mortality rate was decreased from 24.3％ in 2011 to 15.6％ in 2017. Similarly, the recurrent bloodstream infections rate was decreased from 5.6％ to 0％. On the other hand, in 2011 vs 2017, there was no significant difference in the detection rate of resistant bacteria. Taken together, most of the changes in the indicators related to patient outcome analyzed in the present study suggest that AS activities improved the de-escalation rate, and that the de-escalation contributed to the efficacy and safety of antimicrobial therapy.</p>
収録刊行物
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- 医療薬学
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医療薬学 46 (6), 314-322, 2020-06-10
一般社団法人日本医療薬学会
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キーワード
詳細情報 詳細情報について
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- CRID
- 1390851264573906176
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- NII論文ID
- 130008050796
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- ISSN
- 18821499
- 1346342X
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
- OpenAIRE
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- 抄録ライセンスフラグ
- 使用不可
