Page 16 - pest-POSTEN nr 3, 2018

-pest-POSTEN Side 16

og dominert av noen morgenfriske nordmenn. innleggene:
Jeg ga til beste en grundig og oppdatert O0844 Reduced use of broad-spectrum
gjennomgang av de ulike målemetoder for antibiotics due to mandatory antibiotic
antibiotikabruk, fra velkjente DDD over stewardship programmes in Norwegian hospitals
sykehusjusterte” doser, til de for antibiotikastyring Per Espen Akselsen, Marion Neteland, Brita Skodvin,
Stig Harthug.
mer relevante Days- og Length-of-Treatment
(DoT & LoT) samt betydningen av å justere for Background: Use of broad-spectrum antibiotics in
”case-mix” – med vår nasjonale benchmarking Norway has increased the last two decades despite
som et eksempel på hvordan dette ofte ikke skjer.. a relatively low level of antimicrobial resistance.
The majority of Norwegian general hospitals
are publicly funded, and these 55 hospitals
are owned through four regional health
authorities (RHA). In addition, three private
general hospitals with acute care functions are
contracted by RHAs.

Materials/methods: In January 2016 the
Norwegian Government published their
National Action Plan against Antibiotic
Resistance in Health Care (2016-2020), setting
a goal of 30% reduction in antibiotic usage in
the population by the end of 2020 (compared
to 2012). For health trusts the goal is a 30%
reduction (DDD/100 bed days) in the combined
use of five important groups of broad-spectrum
antibiotics (carbapenems, quinolones, 2nd and
Min ”med-ekspert” Vera konsentrert sin del av 3rd generation cephalosporins and penicillins with
timen vår om prosjektet ”DRIVE-AB”, del av beta-lactamase inhibitor combinations).
et 3-årig EU-initiativ ledet av IMI (”Innovative Hospitals are to implement antibiotic stewardship
Medicines Initiative”). Målet er å gi industrien programs (ASP) to reach this goal. The Norwegian
insentiver for å utvikle nye antibiotika, samtidig National Advisory Unit for Antibiotic Use in Hospitals
som man søker etter metoder for å benytte (KAS) monitors the hospitals antibiotic use. It also
eksisterende antibiotika på en bedre måte. For provides antibiotic stewardship support by visits,
sistnevnte mål har man brukt en 4-step RAND- networking, courses, educational material, reports etc.
modifisert Delphi-prosedyre for å komme til KAS will audit the hospitals ASPs in 2018.
konsensus blant eksperter når det gjelder en hel Data for antibiotic use for all publicly financed or
rekke kvalitetsindikatorer for antibiotikabruk – contracted hospitals are retrieved from the hospitals
men også anbefalte målemetoder, uten at valget pharmacies drug statistics database which collects sales
av disse var noen overraskelse – for anvendelse data from each pharmacy delivering drugs to hospitals.
i sykehus. Information on bed days and admissions are collected
from the Norwegian Patient Registry.
(Mye..) senere den mandagen var det tid for Outcome measures are antibiotic use in DDD/100 bed
sesjonen ”Improved antimicrobial prescribing in days presented in a time series 2012-2017
the hospital setting”, der to innlegg fra antibiotika
kompetansesenteret i Bergen (KAS) vakte en Results: By August 2017 four health trusts have
viss oppmerksomhet og ga opphav til flere gode already reached the goal of 30% reduction of broad
spectrum antibiotics, for one smaller hospital the
spørsmål.
reduction is more than 50 %. Nationwide the reduction
I tråd med medlemsbladets profil, i alle fall fra is 11.5 % compared to 2012 and 8.4 % compared to
tidligere tider, velger jeg å gjengi i sin helhet 2016. Reduction in use of broad spectrum use seems to
begge abstracts fra disse muntlig fremførte correlate with well-functioning ASPs. Data for 2012-
2017 (all years) will be presented.