Nijmegen Institute for Infection, Inflammation, and Immunity (N4i) and Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Int J Antimicrob Agents. 2011 Dec;38 Suppl:11-20. doi: 10.1016/j.ijantimicag.2011.09.002. Epub 2011 Oct 21.
There is a clear association between antibiotic use and resistance both on individual and population levels. In the European Union, countries with large antibiotic consumption have higher resistance rates. Antibiotic resistance leads to failed treatments, prolonged hospitalisations, increased costs and deaths. With few new antibiotics in the Research & Development pipeline, prudent antibiotic use is the only option to delay the development of resistance. Antibiotic policy consists of prescribing strategies to optimise the indication, selection, dosing, route of administration, duration and timing of antibiotic therapy to maximise clinical cure or prevention of infection whilst limiting the unintended consequences of antibiotic use, including toxicity and selection of resistant microorganisms. A secondary goal is to reduce healthcare costs without adversely affecting the quality of care. The purpose of this paper is to provide the evidence base of prudent antibiotic policy. Special emphasis is placed on urinary tract infections. The value and support of antibiotic committees, guidelines, ID consultants and/or antimicrobial stewardship teams to prolong the efficacy of available antibiotics will be discussed.
抗生素的使用与个体和人群层面的耐药性之间存在明确关联。在欧盟，抗生素消耗量大的国家耐药率更高。抗生素耐药性导致治疗失败、住院时间延长、成本增加和死亡。由于研发管道中几乎没有新的抗生素，谨慎使用抗生素是唯一可以延迟耐药性发展的选择。抗生素政策包括制定策略，以优化抗生素治疗的适应证、选择、剂量、给药途径、疗程和时机，最大限度地提高临床治愈率或预防感染，同时限制抗生素使用的意外后果，包括毒性和耐药微生物的选择。次要目标是降低医疗保健成本，而不会对护理质量产生不利影响。本文旨在提供合理使用抗生素政策的证据基础。特别强调了尿路感染。将讨论抗生素委员会、指南、ID 顾问和/或抗菌药物管理团队对抗生素的价值和支持，以延长现有抗生素的疗效。
