Gyssens I C, Kullberg B J, van der Meer J W
Erasmus Universitair Medisch Centrum, afd. Medische Microbiologie en Infectieziekten, Rotterdam.
Ned Tijdschr Geneeskd. 1999 Nov 20;143(47):2361-4.
Major reasons to conduct antibiotic policies are to improve the quality of patient care, to limit the emergence of resistance, and to contain costs. Many studies have addressed overconsumption and misuse of antibiotics. Studies have shown a correlation between antibiotic use in hospitals and the development of microbial resistance. Recommendations for the content and management of future antibiotic policy strategies in hospitals include educational programmes, consultation by infectious diseases physicians, restriction of the formulary, timely narrowing of empirical broad spectrum therapy ('streamlining'), and automatic stop orders. A recent study in a Dutch university hospital revealed overconsumption of antibiotics for prophylaxis in surgery and undertreatment with antibiotics in internal medicine departments. Intervention resulted in better compliance with guidelines, reduction of the consumption of antibiotics in surgical prophylaxis, and cost containment. However optimation of antimicrobial therapy also sometimes resulted in an increase of antimicrobial drug consumption.
实施抗生素政策的主要原因是提高患者护理质量、限制耐药性的出现以及控制成本。许多研究都探讨了抗生素的过度使用和滥用问题。研究表明，医院中抗生素的使用与微生物耐药性的发展之间存在关联。关于医院未来抗生素政策策略的内容和管理的建议包括教育项目、传染病医生的会诊、处方集的限制、及时缩小经验性广谱治疗范围（“简化治疗”）以及自动停药指令。荷兰一家大学医院最近的一项研究显示，外科手术中预防性使用抗生素存在过度消费的情况，而内科部门存在抗生素治疗不足的问题。干预措施使指南的依从性更好，手术预防性使用抗生素的消耗量减少，成本得到控制。然而，抗菌治疗的优化有时也会导致抗菌药物消耗量的增加。
