Antibiotic Stewardship Program to optimize antibiotic usage in Hospital Authority

29 Pages·2007·0.73 MB·English

Antibiotic Stewardship Program to optimize
antibiotic usage in Hospital Authority
醫院管理局
Dr. Raymond Yung
抗生素導向計劃
Head, Infection Control Branch, CHP
cum ICASP, the Hospital Authority
8 May 2007
1
Impact of Antibiotic Resistance
Recovery with
Antibiotic treatment
Patient with
successful
Infection
treatment
Antibiotic Resistance
Inappropriate Use of Antibiotic
Cost LOS
The emergence of antibiotic resistance has threatened the successful
treatment of patients with infections, increasing both the drug costs
and length of stay of patients in hospitals.
Inappropriate use of antibiotic can lead to increased resistant pathogens
2
Worldwide Concerns on
Antibiotic Resistance
Resolution of World Health Assembly 2005 :
Improving the containment of antimicrobial
resistance
3
Strategy to Combat
Antimicrobial Resistance
HAHO CHP
DURC CCID
ICASP HPPAR
Cluster
DTC
Community GP Private
Hospital
Cluster Implementation Committee
Policy
(cid:122)
Monitoring
(cid:122)
Surveillance & resistance
(cid:122) Liaison
(cid:122)
Rational use of antibiotics
(cid:122) Education
(cid:122)
Cost-containment
(cid:122)
HAHO –Hospital Authority Head Office
DURC –Drug Utilization Review Committee
CCID –Central Committee on Infectious Disease
ICASP –Implementation Committee on Antibiotic Stewardship Program
CHP –Centre for Health Protection
SCIC –Scientific Committee on Infection Control
4
HPPAR –Health Protection Program on Antimicrobial Resistance
Antibiotic Stewardship Program
Objectives:
• To control the emergence and spread of
antibiotic resistance
• To optimize selection and use of antibiotics
5
ICASP Membership
• Co-chairmen:
– Cluster Clinical Representatives:
– Dr. W L Cheung • HKE: Dr. Rodney Lee
• HKW: Dr. P L Ho
– Dr. S H Liu
• KE: Dr. W K Luk
• KC: Dr. T C Wu
• KW: Dr. T K Ng
• Members:
Dr. W K To
– Dr. Raymond Yung
Dr. Cindy Tse
– Dr. Y W Fan • NTE: Dr. Raymond Lai
• NTW: Dr. T L Que
– Dr. S T Lai
– Dr. Florence Yap
– Cluster Pharmacy Representatives
– Dr. Lawrence Wong
• HKE: Mr. S L Chan
– Dr. N T Cheung • HKW: Mr. William Chui
• KE: Mr. Leo Leung
– Mr. P W Lee
• KC: Mr. K W Ng
– Ms. Anna Lee
• KW: Ms. Rosa Yao
– Ms. Irene Lau • NTE: Dr. Benjamin Lee
• NTW: Ms. Pauline Chu
– Ms. Dora Chan- Secretary
6
Scope
Cluster/Hospital
Overall antibiotic expenditure in HA
• HKE: PYNEH, RH
Other Hospitals
• HKW: QMH, TWH
8%
• KE: UCH, TKOH
• KC: QEH, KH
• KW: PMH, CMC, KWH,YCH
• NTE: PWH, AHNH, NDH 92%
ASP Hospitals
• NTW: TMH
Specialty
-Medicine / Surgery / Intensive Care Unit / Orthopedics
7
Strategies
Multidisciplinary
Antibiotic Monitoring
Antibiotic Stewardship
Team (AST)
Outcome Measurement
and User Feedback
HA Wide
Education and
Antibiotic Usage Database
consensus building
Antibiotic Resistance
Database
8
Antibiotic Stewardship Team (AST)
•Pharmacist
•Microbiologist
•Hospital management
•ID physician
•Senior specialty head
•Infection control nurse
•ICU physician
Role of the AST:
Define work scope, logistics, manpower, task assignments and
time-frame
Manage antibiotic audit
Consultation and promulgation of IMPACT guidelines
Provide education and feedback
Perform data analysis and reporting
9
Strategies
Multidisciplinary
Antibiotic Monitoring
Antibiotic Stewardship
Team (AST)
Outcome Measurement
and User Feedback
HA Wide
Education and
Antibiotic Usage Database
consensus building
Antibiotic Resistance
Database
10