Burgess David S, Rapp Robert P
College of Pharmacy, The University of Texas at Austin, USA.
Am J Health Syst Pharm. 2008 May 1;65(9 Suppl 2):S4-15. doi: 10.2146/ajhp080075.
To address how the high endemic levels of antimicrobial resistance and multidrug resistance in hospitals have challenged clinicians to select appropriate therapy for effectively treating bacterial infections among seriously ill patients.
Among gram-positive bacterial infections, differentiating between healthcare-associated and community-associated methicillin-resistant Staphylococcus aureus infections is becoming more difficult and can seriously impact therapeutic strategies and hence outcomes. Furthermore, the rising prevalence of multidrug-resistant gram-negative bacterial infections is increasing the pressure on proper antimicrobial selection given the dearth of new antimicrobial agents under development. Optimized dosing strategies will be instrumental in minimizing emergence of resistance and preserving the utility of currently available agents. Antimicrobial stewardship programs in conjunction with stringent infection control policies will be critical in improving the appropriate use of antimicrobials while reducing the spread of nosocomial pathogens.
Addressing the challenges of antimicrobial resistance in hospitals will require a multidisciplinary approach, with clinical pharmacists taking a proactive role in ensuring the appropriate use of antimicrobials.
探讨医院中抗菌药物耐药性和多重耐药性的高流行水平如何给临床医生在为重症患者有效治疗细菌感染选择合适疗法时带来挑战。
在革兰氏阳性菌感染中，区分医疗保健相关和社区相关的耐甲氧西林金黄色葡萄球菌感染变得越来越困难，并且会严重影响治疗策略，进而影响治疗结果。此外，鉴于正在研发的新型抗菌药物匮乏，多重耐药革兰氏阴性菌感染的患病率不断上升，这增加了正确选择抗菌药物的压力。优化给药策略将有助于最大限度地减少耐药性的出现，并保持现有药物的效用。抗菌药物管理计划与严格的感染控制政策相结合，对于改善抗菌药物的合理使用、同时减少医院病原体的传播至关重要。
应对医院抗菌药物耐药性挑战需要采取多学科方法，临床药师应积极发挥作用，确保抗菌药物的合理使用。
