Context: In a global environment of escalating antimicrobial resistance and limited new antibiotic development, there is a desire to optimize antibiotic use across all settings to preserve options for the future. Despite this, antibiotics continue to be prescribed inappropriately in many settings. Patients with a spinal cord injury (SCI) are particularly vulnerable to receiving multiple courses of antibiotics, yet there is limited data reviewing antimicrobial stewardship (AMS) programs in this patient population.

Hypothesis: Adopting AMS rounds will reduce days of antibiotic treatment.

Intervention: We implemented a systematic bedside AMS multidisciplinary team (MDT) ward round within the SCI Unit at our hospital, where a collaborative inter-speciality and inter-professional approach was undertaken to address antibiotic prescriptions. A retrospective audit of antibiotic prescriptions was performed one month prior and one month during the intervention.

Outcome measures: An infectious disease consultant led a multidisciplinary, multispecialty ward rounding team, looking at antibiotic appropriateness and guideline compliance. The effectiveness of this intervention was assessed by retrospectively looking at antibiotic days of usage per patient day of occupancy.

Results: Antibiotic consumption significantly decreased following the AMS intervention, from 69.8 to 24.3 days on treatment per 100 patient days (P < 0.001). Following implementation of the ward round the proportion of therapeutic guideline compliant prescriptions significantly rose from 18% in April to 56% in August (P < 0.001).

Conclusions: Utilizing a collaborative inter-speciality and inter-professional AMS approach and providing face to face feedback about the appropriateness of antibiotic prescribing can help optimize antibiotic usage within a SCI unit.

背景：在抗菌素耐药性不断升级和新抗生素开发有限的全球环境中，人们希望优化所有环境中的抗生素使用，以保留未来的选择。尽管如此，在许多情况下，抗生素的处方仍然不恰当。脊髓损伤 (SCI) 患者特别容易接受多个疗程的抗生素治疗，但在该患者群体中审查抗菌药物管理 (AMS) 计划的数据有限。

假设：采用 AMS 轮将减少抗生素治疗的天数。

干预：我们在我们医院的 SCI 科内实施了一个系统的床边 AMS 多学科团队 (MDT) 查房，其中采取了跨专业和跨专业的协作方法来解决抗生素处方问题。在干预前一个月和干预期间进行了抗生素处方的回顾性审核。

结果衡量：一名传染病顾问领导了一个多学科、多专业的病房巡查团队，研究抗生素的适用性和指南的依从性。这种干预的有效性是通过回顾性观察每个患者入住日的抗生素使用天数来评估的。

结果： AMS 干预后抗生素消耗量显着降低，从每 100 个患者天的治疗 69.8 天减少到 24.3 天（P < 0.001）。实施查房后，符合治疗指南处方的比例从 4 月份的 18% 显着上升至 8 月份的 56%（P < 0.001）。

结论：利用协作的跨专业和跨专业 AMS 方法并提供有关抗生素处方适当性的面对面反馈，可以帮助优化 SCI 单位内的抗生素使用。