Department of Microbiology and Communicable Disease, Royal Hampshire County Hospital, Winchester SO22 5DG, UK.
J Antimicrob Chemother. 2011 Nov;66(11):2441-3. doi: 10.1093/jac/dkr370. Epub 2011 Sep 15.
Everyone prescribing antibiotics should consider both their clinical and public health responsibilities. The objective should be to provide optimal patient care while at the same time seeking to minimize selective pressure that may result in the emergence and spread of antibiotic resistance. To this end, in 2008 the European Centre for Disease Control initiated the annual European Antibiotic Awareness Day (EAAD) to take place on 18 November, when Europe-wide activities are undertaken to highlight the critical importance of prudent antibiotic prescribing. This year activities in England will focus on the optimal management of infections in secondary care, and will have two inter-related aims. The first is to improve the quality of the initial decision to prescribe an antibiotic (including making an informed choice of empirical drug and dose) in particular ensuring rapid prescribing and administration in presumed sepsis. This is deliberately combined with a second focus on the critical importance of formally reviewing antibiotic therapy at 48 h, based on the patient's clinical response and the availability of microbiology test results. This should lead to a clear decision to stop, switch to oral, switch to outpatient antibiotic therapy (OPAT) or change antibiotic, if possible to a narrower spectrum. The EAAD campaign in England will highlight the need to 'Start Smart-Then Focus'. The aim is that patients receiving antibiotics should receive the right drug at the right time at the right dose for the right duration.
每位开具抗生素处方的医生都应考虑其临床和公共卫生责任。目标应该是提供最佳的患者护理，同时尽量减少可能导致抗生素耐药性出现和传播的选择性压力。为此，2008 年，欧洲疾病预防控制中心启动了一年一度的欧洲抗生素意识日（EAAD），定于 11 月 18 日举行，届时将在全欧洲范围内开展活动，强调谨慎使用抗生素处方的重要性。今年，英格兰的活动将侧重于二级保健中感染的最佳管理，并将有两个相互关联的目标。第一个目标是提高初始抗生素处方决策的质量（包括做出明智的经验性药物选择和剂量），特别是确保在疑似败血症时迅速进行处方和给药。这与第二个重点刻意结合，即根据患者的临床反应和微生物学检测结果，在 48 小时时正式审查抗生素治疗，这一点至关重要。这应该会做出明确的决定，停止、改用口服、转为门诊抗生素治疗（OPAT）或换用抗生素，如果可能的话，换用更窄谱的抗生素。英格兰的 EAAD 活动将强调需要“明智开始，然后聚焦”。目的是让接受抗生素治疗的患者在正确的时间、以正确的剂量、持续正确的时间接受正确的药物。
