Construction and Practice of Special Management System for Carbapenems in Our Hospital / 中国药房

ABSTRACT

OBJECTIVE：To esta blish a special management system of carbapenems ，and to standardize the clinical and rational application of carbapenem antibacterial drugs. METHODS ：According to the requirements of the relevant documents of National Health Commission of the People ’s Republic of China ，the special management system of carbapenems in the First Affiliated Hospital of University of Science and Technology of China （called“our hospital ”in short ）was constructed. The use intensity，reasonable rate of prescription and the detection rate of carbapenem resistant Enterobacteriaceae were analyzed before and after management. RESULTS ：The special management system of carbapenems in our hospital included organization construction，information construction of special management ，prescription review of special management drugs ，prescription comment intervention and so on. After the implementation of the special management system ，the intensity of carbapenems use decreased from 2.78 to 2.03，the reasonable rate of prescription increased from 62.8％ to 98.3％（P＜0.05）. The detection rates of Acinetobacter baumannii ，Escherichia coli and Pseudomonas aeruginosa resistance to carbapenems decreased from 91.4％，2.4％， 49.5％ to 79.7％，1.6％，39.7％，respectively. However ，the detection rate of Klebsiella pneumoniae resistance to imipenem increased from 34.4％ to 50.0％. CONCLUSIONS ：The special management system of carbapenems in our hospital has achieved some results in practice ，which helps to reduce the abuse of these drugs and improve the reasonable level of drug use and reduce the detection rate of drug-resistant bacteria. At the same time ，hospital infection control of K. pneumoniae resistance to imipenem should be strengthened.