调查肾移植中心抗菌药物管理(AMS)现状，为进一步规范抗菌药物合理用药提供参考。

2023年4月4日至5月12日，面向全国移植药师联盟成员中来自50家医院的肾移植专科临床药师开展在线调查，收集其所在医院及肾移植中心AMS相关情况。通过问卷星平台设计并发布肾移植中心AMS现状调查问卷，内容包括受访药师及其所在医院的基本信息、抗菌药物临床应用管理评价指标及完成情况、药师采取的干预措施与成效、药师对肾移植围手术期感染预防方案的合理性评价与建议等。

共23位来自23家三级甲等教学医院的移植药师参与调查。21家(91.3%)医院开展AMS，仅10家(43.5%)涉及肾移植中心。各中心抗菌药物使用强度目标值存在较大差异，5家(21.7%)未达标。22位药师采取过干预措施以改善抗菌药物合理使用，具体措施包括：开展培训(19位、86.4%)，行政干预(12位、54.5%)，利用合理用药软件辅助AMS管理(6位、27.3%)。干预效果主要体现为：疗程缩短(18位、81.8%)，用药品种调整(12位、54.5%)，联合用药品种数减少(11位、50.0%)，给药剂量减少(6位、27.3%)。12位(52.2%)药师认可所在肾移植中心目前的肾移植手术常规感染预防方案，但不同药师对同一方案的评价结果并不统一。

我国肾移植中心AMS开展率较低，在AMS目标及执行情况等方面存在较大差异，尚需开展高质量研究探索同质化管理策略，以规范抗菌药物合理使用。

To investigate the current status of antimicrobial stewardship (AMS) in kidney transplant centers and provide a reference for further standardizing the rational use of antimicrobial agents.

From April 4 to May 12, 2023, an online survey was conducted for clinical pharmacists specializing in kidney transplantation from 50 hospitals of the National Alliance of Transplant Pharmacists to collect information on AMS-related practices in their respective hospitals and kidney transplant centers. A questionnaire on the current status of AMS in kidney transplant centers was designed and distributed via the " Wenjuanxing" platform. The content included basic information about the responding pharmacists and their hospitals, evaluation indicators and completion status of clinical application management of antimicrobial agents, intervention measures taken by pharmacists and the effectiveness, as well as the rationality evaluation and suggestions from pharmacists on the perioperative infection prevention protocols for kidney transplantation.

A total of 23 transplant pharmacists from 23 teaching hospitals with Grade IIIA participated in the survey. AMS was implemented in 21 hospitals (91.3%), while only 10 hospitals (43.5%) had AMS programs in renal transplant centers. There were substantial differences in the target values for antimicrobial use intensity among the centers, and 5 centers (21.7%) failed to reach the standard. Twenty-two pharmacists had implemented interventions to improve the rational use of antimicrobial agents. Specific interventions included: training programs (19 cases, 86.4%), administrative interventions (12 cases, 54.5%), and the use of rational medication software to support AMS management (6 cases, 27.3%). The effects of interventions were mainly reflected as: shortened treatment courses (18 cases, 81.8%), adjustment of drug choice (12 cases, 54.5%), reduction in the number of combined antimicrobial agents (11 cases, 50.0%), and decreased dosage (6 cases, 27.3%). Twelve pharmacists (52.2%) approved of the current routine infection prophylaxis protocols for kidney transplantation in their centers, however, evaluations of the same protocol varied among different pharmacists.

The implementation rate of AMS in kidney transplant centers in China remains low, and there are substantial differences in AMS goals and implementation. High-quality studies are needed to explore homogeneous management strategies to standardize the rational use of antimicrobial agents.