Gyssens I C
Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Int J Antimicrob Agents. 2001 Jan;17(1):9-19. doi: 10.1016/s0924-8579(00)00208-9.
Antimicrobial use is the major determinant in the development of resistance. Many parameters of importance for optimal quality of antimicrobial therapy have already been defined. Maximal efficacy of the treatment should be combined with minimal toxicity at the lowest cost. Quality of antimicrobial drug use is dependent on knowledge of many aspects of infectious diseases. Considering efficacy, many of our indications for antimicrobial use need critical evaluation. Irrational use should be discouraged. Avoidance of the development of resistance is a quality parameter that will need increasing attention. This paper reviews the well-established factors that may influence the appropriateness of pharmacotherapy with antimicrobial drugs. It cites recent evidence supporting principles of prudent prescribing and gives an overview of audits that have addressed these parameters. Measures relating to resistance are discussed.
抗菌药物的使用是耐药性产生的主要决定因素。抗菌治疗最佳质量的许多重要参数已经明确。治疗的最大疗效应与最低成本下的最小毒性相结合。抗菌药物使用的质量取决于对传染病诸多方面的了解。考虑到疗效，我们许多抗菌药物使用的指征需要严格评估。应避免不合理使用。避免耐药性的产生是一个需要越来越多关注的质量参数。本文综述了可能影响抗菌药物药物治疗适宜性的既定因素。文中引用了支持谨慎处方原则的最新证据，并概述了针对这些参数的审计情况。讨论了与耐药性相关的措施。
