Pujol M, Gudiol F
Infectious Diseases Service, Hospital de Bellvitge 'Princeps d'Espanya', Barcelona, Spain.
Curr Opin Infect Dis. 2001 Dec;14(6):711-5. doi: 10.1097/00001432-200112000-00008.
There is growing concern about the increasing rates of resistance among human pathogens. These high rates of resistance, which are a consequence of antibiotic misuse, highlight the need for a thorough revision of strategies that deal with the proper use of antibiotics. The so-called 'optimal use of all antibiotics', restriction guidelines and use of a combination of antibiotics are well established strategies in most hospitals but new potential strategies, such as dosage optimization and antibiotic cycling, require further study and evaluation. Cycling antibiotic therapy consists of the scheduled replacement of one antibiotic for another, in order to avoid the development of bacterial resistance. Initial studies suggest that this strategy could be useful in reducing the rates of bacterial resistance as well as the incidence of nosocomial infections caused by Gram-negative bacilli in intensive care unit patients. This strategy, however, does not prevent antibiotic misuse and needs to be applied in a complete antibiotic policy program.
人们越来越关注人类病原体耐药率的不断上升。这些高耐药率是抗生素滥用的结果，凸显了彻底修订抗生素合理使用策略的必要性。所谓的“所有抗生素的优化使用”、限制指南以及联合使用抗生素，在大多数医院都是既定的策略，但新的潜在策略，如剂量优化和抗生素轮换，需要进一步研究和评估。轮换抗生素疗法是指定期将一种抗生素替换为另一种抗生素，以避免细菌产生耐药性。初步研究表明，这一策略可能有助于降低耐药率以及重症监护病房患者中由革兰氏阴性杆菌引起的医院感染发生率。然而，这一策略并不能防止抗生素滥用，需要在完整的抗生素政策计划中应用。
