Antibiotic Stewardship without an Antibiotic Stewardship Program?
Notice bibliographique
Résumé
To promote heightened vigilance concerning antibiotic agents in Canadian hospitals, Accreditation Canada has implemented antibiotic stewardship as a required organizational practice.1 Antibiotic stewardship is the process of ensuring that only necessary and appropriate antibiotic agents are used and that their use is appropriate for each individual patient. It involves optimizing all steps of antibiotic therapy, including appropriate selection, dosing, route, and duration. Through antibiotic stewardship strategies, a hospital can optimize the use of antibiotics, reduce the risk of opportunistic infections, stabilize or reduce antibiotic resistance, promote patient safety, and reduce health care costs.1,2 According to the American Society of HealthSystem Pharmacists, pharmacists have the ability, while providing care to individual patients, to effectively participate in antibiotic stewardship through their activities as members of health care teams and committees and by using their knowledge and abilities to focus on proper antibiotic utilization.3,4 The current study was conducted within the Providence Health Care health authority, which comprised 2 acute care hospitals and several residential facilities in the lower mainland of British Columbia. In this health authority, pharmacistinitiated antibiotic stewardship practices have been in place for many years, despite the absence of a formal antibiotic stewardship program. No pharmacists or physicians were specifically assigned responsibility for ensuring that antibiotic use was appropriate for admitted patients. However, pharmacists at Providence Health Care were involved on a day-to-day basis in pharmaceutical care related to all aspects of drug therapy for admitted patients, including antibiotic therapy. In the course of providing care, pharmacists frequently performed antibiotic stewardship activities, such as making recommendations to narrow the spectrum of activity of prescribed therapy, adjusting dosages, stepping down from parenteral to oral therapy, stopping unnecessary antibiotics, and switching to more appropriate antibiotics. The Antibiotic Subcommittee of the health authority’s Pharmacy and Therapeutics Committee had established restrictions, procedures, and recommendations regarding the use of antibiotic agents. The Pharmacy Department had an expectation that all pharmacists would perform activities appropriate for ensuring the optimal use of antibiotic agents. The purpose of this study was to quantify the antibiotic stewardship activities performed by pharmacists at Providence Health Care before implementation of a formal anti biotic stewardship program. A literature search identified no studies quantifying antibiotic stewardship activities performed by pharmacists in any Canadian hospital. The primary objective of the study was to quantify the various potential antibiotic stewardship activities related to target broad-spectrum antibiotics at St Paul’s Hospital and Mount Saint Joseph Hospital, the 2 acute care hospitals within Providence Health Care. The primary outcome was the proportion of patients included in the review who received the target antibiotics and experienced at least one antibiotic stewardship intervention by a pharmacist. The secondary objective was to determine the frequency of each type of antibiotic stewardship intervention.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,033 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,003 |
| Communication savante | 0,005 | 0,005 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,004 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».