Crnich Christopher J, Jump Robin, Trautner Barbara, Sloane Philip D, Mody Lona
School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, MFCB 5217, Madison, WI, 53705, USA.
William S. Middleton Veterans Affairs Hospital, Madison, WI, USA.
Drugs Aging. 2015 Sep;32(9):699-716. doi: 10.1007/s40266-015-0292-7.
The emerging crisis in antibiotic resistance and concern that we now sit on the precipice of a post-antibiotic era have given rise to advocacy at the highest levels for widespread adoption of programmes that promote judicious use of antibiotics. These antibiotic stewardship programmes, which seek to optimize antibiotic choice when clinically indicated and discourage antibiotic use when clinically unnecessary, are being implemented in an increasing number of acute care facilities, but their adoption has been slower in nursing homes. The antibiotic prescribing process in nursing homes is fundamentally different from that observed in hospital and clinic settings, with formidable challenges to implementation of effective antibiotic stewardship. Nevertheless, an emerging body of research points towards ways to improve antibiotic prescribing practices in nursing homes. This review summarizes the findings of this research and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting.
抗生素耐药性危机的出现，以及人们对我们正处于后抗生素时代边缘的担忧，引发了最高层对广泛采用促进合理使用抗生素计划的倡导。这些抗生素管理计划旨在在临床有指征时优化抗生素选择，并在临床无必要时抑制抗生素使用。越来越多的急性护理机构正在实施这些计划，但养老院对其采用速度较慢。养老院的抗生素处方流程与医院和诊所环境中的流程有根本不同，有效实施抗生素管理面临巨大挑战。尽管如此，越来越多的研究指出了改善养老院抗生素处方做法的方法。本综述总结了这项研究的结果，并提出了在养老院环境中实施和优化抗生素管理的方法。
