抗菌药物管理评价指标和评估方法研究进展

Research Progress on Evaluation Outcomes and Study Designs of Antimicrobial Stewardship Programs

抗菌药物管理项目(antimicrobial stewardship program,ASP)是一项由多学科医疗团队干预抗菌药物使用以促进抗菌药物合理使用、保障医疗质量和医疗安全的干预项目。随着抗菌药物管理的开展,确定合适的评价方法和评价指标作为证明ASP干预措施有效性至关重要。笔者通过查阅梳理国内外抗菌药物管理政策效果评价领域的相关文献,对不同评价指标与评价方法等方面进行了综述。总结了ASP主要的4个指标:临床结局指标、微生物指标、过程指标、经济学效益,以及包括随机对照试验、随机整群对照试验、中断时间序列分析、Meta分析等ASP的评价方法,为进一步完善抗菌药物管理政策提供参考,也为后续相关研究提供方向和依据。

The Antimicrobial Stewardship Program(ASP)is a work in which multidisciplinary medical teams intervene in the use of antibacterial drugs to promote rational clinical drug use and ensure medical quality and safety.With the development of antimicrobial management,it is very important to determine appropriate evaluation methods and outcomes to prove the effectiveness of ASP interventions.This paper reviews different evaluation indicators and methods by reviewing the relevant literature in the field of evaluation of the effectiveness of antimicrobial drug management policies at home and abroad.This paper summarizes the four main outcomes of ASP:clinical outcomes,microbial outcomes,process outcomes,economic outcomes,and methodology,including randomized controlled trials,randomized cluster controlled trial,interruption time series analysis and meta analysis.This paper could provide reference for further improving the management policy of ASP,and also provide direction and basis for subsequent related research.