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[抗生素管理:优化抗菌治疗的措施]

[Antibiotic stewardship: Measures for optimization of antibacterial therapy].

作者信息

de With K

出版信息

Internist (Berl). 2015 Nov;56(11):1264-70. doi: 10.1007/s00108-015-3706-z.

Abstract

Because the development of resistance is steadily increasing, especially among Gram-negative pathogens and new developments in antibiotics are lacking, a rational antibiotic therapy is necessary now more than ever. A continuing uncritical and non-guideline-conform use of antibiotics leads to selection of multidrug-resistant pathogens, which can colonize patients and as instigators of infections make treatment more difficult. A prerequisite for targeted antibiotic therapy is a critical testing of the suspected infection diagnosis based on a guideline-conform microbiological preanalytical procedure. To promote a guideline-conform antibiotic therapy in hospitals with respect to choice of substance, dosage and duration, in December 2013 so-called antibiotic stewardship (ABS) measures were summarized in a so-called S3-guideline from the Association of the Scientific Medical Societies in Germany (AWMF) under the auspices of the German Society for Infectious Diseases (DGI). With a strategy of targeted antibiotic therapy and infection prevention it is possible to achieve optimum treatment results and to minimize the development of resistance.

摘要

由于耐药性的发展在不断增加,尤其是在革兰氏阴性病原体中,而且抗生素缺乏新的进展,因此现在比以往任何时候都更需要合理的抗生素治疗。持续无批判地、不遵循指南使用抗生素会导致多重耐药病原体的产生,这些病原体可在患者体内定植,并作为感染的诱因使治疗更加困难。针对性抗生素治疗的一个前提是基于符合指南的微生物学分析前程序对疑似感染诊断进行严格检测。为了在医院中促进在药物选择、剂量和疗程方面符合指南的抗生素治疗,2013年12月,在德国传染病学会(DGI)的主持下,德国科学医学协会联合会(AWMF)在一份所谓的S3指南中总结了所谓的抗生素管理(ABS)措施。通过针对性抗生素治疗和感染预防策略,可以实现最佳治疗效果,并将耐药性的发展降至最低。

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