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摘要：
Objective To evaluate the effect of pharmacist-driven antimicrobial stewardship based on value-based healthcare in a tertiary hospital in China. Methods The application of plan-do-check-action (PDCA) cycle and antimicrobial stewardship (AMS) were respectively used to improve the rational use of antimicrobial agents in prophylactic and therapeutic. Data were collected and the effect was assessed during the management period (2016-2019). Results and Conclusion From 2016 (before implementation) to 2019 (after implementation), the rational use of antibiotics were obviously enhanced in outpatients, inpatients, and emergency department. For instance, the utilization rate in type I incision operation was decreased from 26.42 % to 14.60 % (P = 0.000), the daily doses of antibiotic per 100 patient-days decreased from 49.34 ± 2.97 to 35.89 ± 4.96 (P = 0.000), and the average antibiotic expenditures dropped from 948.53 yuan to 526.30 yuan (P = 0.000). There was no significant change in infection rate, nosocomial mortality rate, and the length of hospital stay. After the implementation of clinical pharmacistdriven antimicrobial stewardship based on value-based healthcare, the consumption and cost of antibacterial have been greatly reduced. Therefore, the pharmacist-driven antimicrobial stewardship increases its value.
