Lim Ching Jou, Kong David C M, Stuart Rhonda L
Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia.
Monash Infectious Diseases, Monash Health, Clayton, VIC, Australia ; Department of Medicine, Monash University, Clayton, VIC, Australia.
Clin Interv Aging. 2014 Jan 13;9:165-77. doi: 10.2147/CIA.S46058. eCollection 2014.
Residential aged care facilities are increasingly identified as having a high burden of infection, resulting in subsequent antibiotic use, compounded by the complexity of patient demographics and medical care. Of particular concern is the recent emergence of multidrug-resistant organisms among this vulnerable population. Accordingly, antimicrobial stewardship (AMS) programs have started to be introduced into the residential aged care facilities setting to promote judicious antimicrobial use. However, to successfully implement AMS programs, there are unique challenges pertaining to this resource-limited setting that need to be addressed. In this review, we summarize the epidemiology of infections in this population and review studies that explore antibiotic use and prescribing patterns. Specific attention is paid to issues relating to inappropriate or suboptimal antibiotic prescribing to guide future AMS interventions.
老年护理机构越来越被认为感染负担沉重,这导致了随后的抗生素使用,而患者人口统计学特征和医疗护理的复杂性又使情况更加复杂。特别令人担忧的是,在这一弱势群体中最近出现了多重耐药菌。因此,抗菌药物管理(AMS)计划已开始被引入老年护理机构环境,以促进合理使用抗菌药物。然而,要成功实施AMS计划,在这个资源有限的环境中存在一些需要解决的独特挑战。在这篇综述中,我们总结了该人群的感染流行病学,并回顾了探索抗生素使用和处方模式的研究。特别关注与不适当或次优抗生素处方相关的问题,以指导未来的AMS干预措施。