Osthoff M, Bielicki Julia, Widmer Andreas F-X
University of Basel Hospitals, University of Basel, Switzerland.
Department for Paediatric Infectious Diseases and Paediatric Pharmacology Group, University of Basel Children's Hospital, Basel, Switzerland.
Swiss Med Wkly. 2017 Oct 20;147:w14512. doi: 10.4414/smw.2017.14512. eCollection 2017.
Antimicrobial stewardship (AMS) is an important component in the fight against antimicrobial resistance. Currently, few hospitals have an ongoing institutional AMS programme. Swissnoso - the national centre for infection prevention - has launched a national Swiss AMS initiative supported by the office of public health. To guide AMS priorities and resources, current AMS activities in Switzerland were assessed. We distributed an internet-based questionnaire directed mainly to board-certified infectious diseases specialists and, if not available, senior internal medicine staff. Responses were received from 63/134 hospitals surveyed. More than 90% were in favour of national treatment guidelines currently in development under the umbrella of the Swiss society for infectious diseases. Many AMS activities - such as antimicrobial formulary restrictions and approval systems, review of antimicrobial prescriptions with point of care intervention, and direct feedback or therapeutic drug monitoring - are currently lacking in the majority of Swiss hospitals surveyed. Development of a modular formal AMS standard for Swiss hospitals may aid in advancing current AMS strategies and in introducing AMS programmes in Switzerland. In combination with the surveillance of antimicrobial use and resistance by ANRESIS, the national antimicrobial resistance surveillance system, this approach may reduce the use of antimicrobial agents and consequently the risk of emergence of multi-resistant pathogens.
抗菌药物管理（AMS）是抗击抗菌药物耐药性的重要组成部分。目前，很少有医院开展持续的机构性AMS项目。瑞士国家感染预防中心Swissnoso在公共卫生办公室的支持下发起了一项全国性的瑞士AMS倡议。为了指导AMS的重点工作和资源分配，对瑞士目前的AMS活动进行了评估。我们分发了一份主要针对获得委员会认证的传染病专家的基于互联网的调查问卷，若没有此类专家，则面向内科高级医护人员。在接受调查的134家医院中，有63家回复了问卷。超过90%的受访者支持目前在瑞士传染病协会框架下制定的国家治疗指南。在接受调查的大多数瑞士医院中，目前缺乏许多AMS活动，如抗菌药物处方集限制和审批系统、在床边护理时对抗菌药物处方进行审查并进行干预、直接反馈或治疗药物监测等。为瑞士医院制定模块化的正式AMS标准可能有助于推进当前的AMS策略，并在瑞士引入AMS项目。结合国家抗菌药物耐药性监测系统ANRESIS对抗菌药物使用和耐药性的监测，这种方法可能会减少抗菌药物的使用，从而降低多重耐药病原体出现的风险。
