抗生素管理介入措施對臨床用藥行為與抗藥性影響之分析

This paired pre-post intervention study was conducted to evaluate the effectiveness of the Antimicrobial Stewardship Program (ASP) in clinical practice at Can Tho University of Medicine and Pharmacy Hospital. A total of 380 inpatients from various clinical departments were enrolled, comprising 190 patients assessed before and 190 patients evaluated after ASP implementation. The baseline rate of appropriate antibiotic use was 51.1%. Statistically significant variations were observed among clinical specialties, with the Internal Medicine group demonstrating higher appropriateness than the Surgical group in indication (100% vs. 78.3%, p < 0.001), dosage (91.8% vs. 78.3%, p = 0.022), and antibiotic combination (81.3% vs. 35.3%, p < 0.001). The presence of microbiological test results confirming infection was a strong predictor of appropriate prescribing, increasing the likelihood by 4.42 times (OR = 4.42, p = 0.003); however, the overall rate of microbiological culture testing remained limited at 36.2%. After ASP implementation, the program demonstrated initial effectiveness, with the most notable and statistically significant improvement observed in the route of antibiotic administration, where appropriateness increased from 93.7% to 100% (p = 0.002). This suggests that standardized interventions, such as promoting the intravenous-to-oral switch, can be implemented efficiently. Nevertheless, the overall appropriateness rate increased only slightly from 51.1% to 52.1%, with no significant enhancement in more complex prescribing aspects such as dosage and antibiotic combination. In conclusion, the ASP proved to be a valuable and beneficial intervention that contributes to optimizing antibiotic use and standardizing clinical practice. However, to achieve sustainable and comprehensive improvement, more intensive, targeted, and multidisciplinary strategies are required.