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“明智选择”:传染病领域的倡议

The "Choosing Wisely": initiative in infectious diseases.

作者信息

Jung Norma, Lehmann Clara, Fätkenheuer Gerd

机构信息

First Department of Internal Medicine, University Hospital of Cologne, Kerpener Str. 62, 50934, Cologne, Germany.

German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.

出版信息

Infection. 2016 Jun;44(3):283-90. doi: 10.1007/s15010-015-0848-9. Epub 2015 Oct 13.

Abstract

PURPOSE

"Choosing Wisely" is a growing international campaign aiming on practice changes to improve patient health through avoidance of unnecessary diagnostic and therapeutic procedures. Our objective was to give an overview on recommendations related to diagnostic and therapeutic issues in infectious diseases from the "Top Five" lists of different medical societies and countries.

METHODS

11 countries featuring specific interest in "Choosing Wisely" met in 2014 to learn from each other about their specific campaigns. These countries were checked for released "Top Five" lists and subsequently screened for issues related to infectious diseases (ID). Recommendations containing the terms "infection", "antibiotics", "antimicrobials", "antifungals", "antivirals", "vaccination", "resistance" and "cultures" were defined as related to ID.

RESULTS

In 7 out of 11 countries "Top Five" lists have been released. Topics of infectious diseases were related to treatment, diagnostics and prevention and present in 51 out of 628 recommendations (8 %) in all countries except Japan. Notably, unnecessary use of antibiotics in upper respiratory tract infections and asymptomatic bacteriuria were cited by several societies from different countries.

CONCLUSIONS

Several societies include topics referring to ID in their recommendations which reflect the high relevance for this field with the overuse of antibiotics as the major concern.

摘要

目的

“明智选择”是一项日益壮大的国际运动,旨在通过避免不必要的诊断和治疗程序来改变医疗行为,以改善患者健康状况。我们的目的是概述不同医学协会和国家的“五大”清单中与传染病诊断和治疗问题相关的建议。

方法

2014年,11个对“明智选择”特别感兴趣的国家齐聚一堂,相互学习各自的具体活动。检查这些国家发布的“五大”清单,随后筛选与传染病(ID)相关的问题。包含“感染”“抗生素”“抗菌药物”“抗真菌药物”“抗病毒药物”“疫苗接种”“耐药性”和“培养”等术语的建议被定义为与ID相关。

结果

11个国家中有7个发布了“五大”清单。传染病主题涉及治疗、诊断和预防,在除日本外的所有国家的628条建议中有51条(8%)涉及这些主题。值得注意的是,来自不同国家的多个协会都提到了上呼吸道感染和无症状菌尿症中抗生素的不必要使用。

结论

几个协会在其建议中纳入了与ID相关的主题,这反映了该领域的高度相关性,其中抗生素的过度使用是主要关注点。

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