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[多重耐药菌——抗生素处方与最后手段抗生素]

[Multiresistant Bacteria - Antibiotic Prescription and Antibiotics of Last Resort].

作者信息

Kern Winfried V

出版信息

Dtsch Med Wochenschr. 2018 May;143(9):643-650. doi: 10.1055/s-0043-119958. Epub 2018 Apr 23.

Abstract

Ascertaining critical indications for antibiotics and rational prescribing can delay and minimize the spread of antibiotic resistance. Room for improvement lies in particular in a stricter indication, in shortening antibiotic treatment and in initiating more targeted therapies with narrow-spectrum drugs. Not all infections due to multidrug-resistant organisms require treatment with reserve drugs. Detailed susceptibility testing together with enhanced knowledge of pharmacokinetics and -dynamics are needed for adequate treatment decisions. There are some new drugs with interesting spectrum of activity in development. The problem of antimicrobial resistance in human medicine, however, must also be seen in the context of "One Health" interactions between various systems including environmental issues and food production.

摘要

确定抗生素的关键指征并合理用药可以延缓并尽量减少抗生素耐药性的传播。尤其在更严格的指征、缩短抗生素治疗时间以及启动更多使用窄谱药物的靶向治疗方面仍有改进空间。并非所有由多重耐药菌引起的感染都需要使用储备药物治疗。为了做出充分的治疗决策,需要进行详细的药敏试验以及增强对药代动力学和药效学的了解。有一些具有有趣活性谱的新药正在研发中。然而,人类医学中的抗菌药物耐药性问题也必须在包括环境问题和食品生产在内的各种系统之间“同一健康”相互作用的背景下看待。

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