著者

丹羽 隆 篠田 康孝 鈴木 昭夫 大森 智史 太田 浩敏 深尾 亜由美 安田 満 北市 清幸 松浦 克彦 杉山 正 村上 啓雄 伊藤 善規

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.5, pp.273-281, 2012-05-10 (Released:2013-05-10)

参考文献数

38

被引用文献数

1 15

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Antimicrobial resistance in hospitals is increasingly becoming a major problem worldwide, thus appropriate use of antimicrobial agents should be promoted. Since August 2009, our hospital has established a review system for checking prescriptions in all patients receiving antimicrobial injections according to the intervention and feedback of antimicrobial stewardship (AMS) guideline. The antimicrobial use density (AUD), duration of administration, length of hospital stay, and antimicrobial resistance in a year were compared before and after starting the intervention into AMS. Suggestions made by members of the infection control team (ICT) to the prescribers were for the major part the choice and dose elevation of antimicrobials. Most of the proposals (91%) were accepted by the prescribers. Although AUD was not changed after AMS intervention, the proportion of prolonged antimicrobial use (over 2 weeks) was significantly reduced from 5.2% to 4.1% (p=0.007), which led to the saving of costs for antibiotics (4.48 million yen/ year). The incidence of MRSA tended to decrease after AMS intervention (p=0.074). The median length of hospital stay was ultimately shortened by 1.0 day (p=0.0005), which led to an estimated saving of medical costs by 520 million yen/year. We consider that our intervention profoundly affects this cost saving. These findings suggest that the extensive intervention into AMS is effective in reducing the frequency of inappropriate use of antimicrobials, suppressing the occurrence of antimicrobial resistance, and saving medical expenses.

著者

堀江 憲吾 亀山 紘司 水谷 晃輔 菅原 崇 清家 健作 土屋 朋大 安田 満 横井 繁明 仲野 正博 出口 隆 酒々井 夏子 広瀬 善信

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 = Acta urologica Japonica (ISSN:00181994)

巻号頁・発行日

vol.60, no.10, pp.517-521, 2014-10

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A 72-year-old Japanese man was referred to a hospital because of urinary retention. Digital rectal examination revealed a stony, hard nodule in the prostate. A high level of serum PSA was not detected. Prostatic biopsy was performed, and pathological examination indicated adenocarcinoma of the prostate. He was referred to our hospital for treatment. Imaging examinations revealed no metastases (T4N0M0), so we re-evaluated the biopsy specimens. Immunohistochemical examination revealed prostatic small cell carcinoma. His levels of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide (Pro-GRP) were high. We treated him with combination chemotherapy comprising irinotecan and cisplatin, and the treatment waseffective. After four coursesof the chemotherapy, levelsof NSE and Pro-GRP had decreased, and the prostatic mass had decreased in size. Needle rebiopsy of the prostate demonstrated no evidence of malignancy. Adjuvant external beam radiation therapy wasals o performed. The patient iss till alive at 18 month after diagnosis with no evidence of relapse or metastasis of the disease.

著者

安田 満

出版者

明星大学経済学部経済学科研究室

雑誌

明星大学経済学研究紀要 (ISSN:03855678)

巻号頁・発行日

vol.40, no.1, pp.[25]-33, 2008-12-25