Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania and Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;
Section of Infectious Disease, Department of Pediatrics, Children's Mercy Hospital and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri; and.
Pediatrics. 2021 Jan;147(1). doi: 10.1542/peds.2020-040295.
Antibiotic overuse contributes to antibiotic resistance, which is a threat to public health. Antibiotic stewardship is a practice dedicated to prescribing antibiotics only when necessary and, when antibiotics are considered necessary, promoting use of the appropriate agent(s), dose, duration, and route of therapy to optimize clinical outcomes while minimizing the unintended consequences of antibiotic use. Because there are differences in common infectious conditions, drug-specific considerations, and the evidence surrounding treatment recommendations (eg, first-line therapy, duration of therapy) between children and adults, this statement provides specific guidance for the pediatric population. This policy statement discusses the rationale for inpatient and outpatient antibiotic stewardship programs; essential personnel, infrastructure, and activities required; approaches to evaluating their effectiveness; and gaps in knowledge that require further investigation. Key guidance for both inpatient and outpatient antibiotic stewardship programs are provided.
抗生素的过度使用导致了抗生素耐药性的出现，这对公众健康构成了威胁。抗生素管理是一种专门的实践，致力于仅在必要时开具抗生素，并且在认为抗生素是必要的情况下，促进使用适当的药物、剂量、疗程和治疗途径，以优化临床结果，同时最小化抗生素使用的意外后果。由于儿童和成人之间存在常见感染性疾病、药物特异性考虑因素以及治疗建议（例如一线治疗、治疗持续时间）方面的差异，因此本声明为儿科人群提供了具体指导。本政策声明讨论了住院和门诊抗生素管理计划的基本原理；所需的关键人员、基础设施和活动；评估其效果的方法；以及需要进一步研究的知识空白。为住院和门诊抗生素管理计划提供了关键指导。
