항균제 사용관리 전산프로그램이 항균제처방에 미치는 영향

Abstract

An inappropriate use of antimicrobials may cause increased bacterial resistance, consequently decrease the efficacy and increase the medical cost. To inhibit bacterial resistance and promote the proper use of antimicrobials, an antimicrobial control program has been linked to the EMR Order System of Seoul National University Hospital since October 2004. The study intended to evaluate the effects of an interlocking antimicrobial control program with EMR order system on parenteral antimicrobial use. All adult (over 19-year-old) inpatients who were administered antimicrobials at least one time during the baseline period (January-March 2003) and the intervention period (January-March 2005) were included. In this study, antifungal and antiviral agents were excluded. Before (2003) and after (2005) the interlock, DDDs/100 patient-days, number of prescriptions, changes in distribution ratio, and the purpose of antimicrobial use were compared. The data was collected from EMR and evaluated retrospectively. In terms of DDDs/100 patient-days, the values of reserved antimicrobials decreased (-2.14%) but those of general(+9.95%) and restricted (+29.84%) antimicrobials increased after the interlock. Although the number of patients prescribed antimicrobials increased (5,826 vs 6,236) and the number of antimicrobial prescriptions increased (57,848 vs 59,755), the proportion of patients administered with antimicrobials decreased (54.7% vs 53.9%), and the number of antimicrobial prescriptions per patient also decreased. Based on these results, the antimicrobial control program showed some positive restricting effects on the antimicrobial use.