Leo Fabian, Stegemann Miriam Songa, Maurer Florian
Dtsch Med Wochenschr. 2020 Mar;145(6):383-392. doi: 10.1055/a-0993-1164. Epub 2020 Mar 19.
Antibiotic stewardship (ABS) denotes structured and continuous measures to improve the quality of prescribing anti-infectives. The aim is to achieve optimal treatment results and to minimize undesirable effects, especially the emergence of antibiotic resistance. This review summarizes the most important ABS principles based on recently published studies with implications for the management of community-acquired pneumonia. Local guidelines, education and training and "prospective audit and feedback" are established strategies to improve the management of patients with community-acquired pneumonia. However, the implementation of ABS programs requires trained personnel and may be impeded by limited structural and time resources. Hence, electronic health records and computer-based interventions are useful support for ABS programs and offer potential to facilitate ABS in inpatient and outpatient care. PCR-based rapid diagnostic tests, PCT-guided algorithms and penicillin allergy testing are suitable procedures to supplement ABS programs.
抗生素管理（ABS）是指为提高抗感染药物处方质量而采取的结构化且持续的措施。其目的是实现最佳治疗效果，并将不良影响降至最低，尤其是抗生素耐药性的出现。本综述基于最近发表的研究，总结了最重要的ABS原则，这些原则对社区获得性肺炎的管理具有重要意义。当地指南、教育与培训以及“前瞻性审核与反馈”是改善社区获得性肺炎患者管理的既定策略。然而，ABS项目的实施需要经过培训的人员，并且可能会受到结构和时间资源有限的阻碍。因此，电子健康记录和基于计算机的干预措施对ABS项目很有用，并为在住院和门诊护理中促进ABS提供了潜力。基于聚合酶链反应（PCR）的快速诊断测试、降钙素原（PCT）引导的算法以及青霉素过敏测试是补充ABS项目的合适方法。
