Kollef M H
Department of Internal Medicine, Pulmonary and Critical Care Division, Washington University School of Medicine, Barnes-Jewish Hospital, Campus Box 8052, 660 South Euclid Avenue, St Louis, MO 63110, USA.
Crit Care. 2001 Aug;5(4):189-95. doi: 10.1186/cc1022. Epub 2001 Jun 28.
Antibiotics are one of the most common therapies administered in the intensive care unit setting. In addition to treating infections, antibiotic use contributes to the emergence of resistance among pathogenic microorganisms. Therefore, avoiding unnecessary antibiotic use and optimizing the administration of antimicrobial agents will help to improve patient outcomes while minimizing further pressures for resistance. This review will present several strategies aimed at achieving optimal use of antimicrobial agents. It is important to note that each intensive care unit should have a program in place which monitors antibiotic utilization and its effectiveness. Only in this way can the impact of interventions aimed at improving antibiotic use (e.g. antibiotic rotation, de-escalation therapy) be evaluated at the local level.
抗生素是重症监护病房中最常用的治疗方法之一。除了治疗感染外，抗生素的使用还会促使致病微生物产生耐药性。因此，避免不必要的抗生素使用并优化抗菌药物的给药方式，将有助于改善患者的治疗效果，同时最大程度地减少耐药性产生的进一步压力。本综述将介绍几种旨在实现抗菌药物最佳使用的策略。需要注意的是，每个重症监护病房都应制定一项计划，监测抗生素的使用情况及其有效性。只有这样，才能在地方层面评估旨在改善抗生素使用的干预措施（如抗生素轮换、降阶梯治疗）的效果。
