Division of Healthcare Quality Promotion, CDC.
MMWR Recomm Rep. 2016 Nov 11;65(6):1-12. doi: 10.15585/mmwr.rr6506a1.
The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC released the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management. The four core elements of outpatient antibiotic stewardship are commitment, action for policy and practice, tracking and reporting, and education and expertise. Outpatient clinicians and facility leaders can commit to improving antibiotic prescribing and take action by implementing at least one policy or practice aimed at improving antibiotic prescribing practices. Clinicians and leaders of outpatient clinics and health care systems can track antibiotic prescribing practices and regularly report these data back to clinicians. Clinicians can provide educational resources to patients and families on appropriate antibiotic use. Finally, leaders of outpatient clinics and health systems can provide clinicians with education aimed at improving antibiotic prescribing and with access to persons with expertise in antibiotic stewardship. Establishing effective antibiotic stewardship interventions can protect patients and improve clinical outcomes in outpatient health care settings.
《门诊抗生素管理的核心要素》为门诊临床医生和经常提供抗生素治疗的医疗机构提供了抗生素管理框架。本报告补充了其他临床环境的现有指导意见。2014 年和 2015 年,分别发布了《医院抗生素管理计划的核心要素》和《疗养院抗生素管理的核心要素》。抗生素管理是衡量和改善临床医生开具抗生素和患者使用抗生素的方式的努力。改善抗生素处方涉及实施有效策略来调整处方实践,使其与基于证据的诊断和管理建议保持一致。门诊抗生素管理的四个核心要素是承诺、政策和实践行动、跟踪和报告以及教育和专业知识。门诊临床医生和医疗机构负责人可以承诺改善抗生素处方,并通过实施至少一项旨在改善抗生素处方实践的政策或措施来采取行动。门诊诊所和医疗保健系统的临床医生和负责人可以跟踪抗生素处方实践,并定期将这些数据报告给临床医生。临床医生可以向患者和家属提供有关适当使用抗生素的教育资源。最后,门诊诊所和医疗系统的负责人可以为临床医生提供旨在改善抗生素处方和提供抗生素管理专业知识的人员的教育。在门诊医疗环境中建立有效的抗生素管理干预措施可以保护患者并改善临床结果。