Objectives‘National Special Stewardship in the Clinical Use of Antibiotics’ was put forward in July 2011 in China. We aimed to retrospectively evaluate the impact of antimicrobial stewardship (AMS) managed by clinical pharmacists on antibiotic utilisation, prophylaxis and antimicrobial resistance (AMR).DesignThis was a retrospective observational study of trends in antibiotic use and AMR in the context of AMS.SettingBeijing Chaoyang Hospital, a 1400-bed tertiary hospital, in China.Data and participantsAntibiotic prescriptions from 820 doctors included all outpatients (n=17 766 637) and inpatients (n=376 627) during 2010–2016. Bacterial resistance data were from all inpatients (n=350 699) during 2011–2016.InterventionsMultiaspect intervention measures were implemented by clinical pharmacists (13 persons), for example, formulating the activity programme and performance management, advising on antibacterial prescriptions and training.Outcome measuresThe proportion of antibiotic prescriptions among outpatients and inpatients, intensity of consumption in defined daily dose (DDD)/100 bed-days, antibiotic prophylaxis in type I incision operations and resistance rates ofEscherichia coli,Klebsiella pneumoniaeandPseudomonas aeruginosawere retrospectively analysed.ResultsThe proportion of antibiotic prescriptions decreased in outpatients (from 19.38% to 13.21%) and in inpatients (from 64.34% to 34.65%), the intensity of consumption dropped from 102.46 to 37.38 DDD/100 bed-days. The proportion of antibiotic prophylaxis decreased from 98.94% to 18.93%. The proportion of rational timing of initial dose increased from 71.11% to 96.74%, the proportion of rational duration rose from 2.84% to 42.63%. Time series analysis demonstrated the resistance rates ofE. coliandP. aeruginosato fluoroquinolones decreased, the incidence rate of methicillin-resistantStaphylococcus aureusalso decreased, whereas the resistance rates ofE. coliandK. pneumoniaeto carbapenems increased. The antibiotic use was partly positively correlated with AMR.ConclusionsAMS had an important role in reducing antibiotic use and surgical antibiotic prophylaxis. The AMR was positively correlated with antibiotic consumption to some extent.
Precise control of
the motion of micromachines is the key to achieving
their functions for practical applications. The main challenge is
that a given micromachine can typically exhibit only one motion mode,
i.e., translation or rotation, while having multiple modes of motion
resulting from a simple actuation is still rare. Here we designed
and synthesized photochemically powered zinc oxide/gold (ZnO/Au) rods
that exhibit multiple motion modes. Under homogeneous UV irradiation,
these ZnO/Au rods undergo a transition from ballistic motion to persistent
rotational motion upon increasing the fuel concentration or the light
intensity. In addition, the rods can switch modes from a circular
motion to a helical motion and then a straight-line motion by tuning
the angle of incident light. We envision that such attractive colloidal
micromachines with controllable motions hold considerable promise
for diverse practical applications.
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