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抗生素管理在泌尿外科和尿路感染中的重要性日益增加——快速综述。

Rising significance of antibiotic stewardship in urology and urinary tract infections - a rapid review.

机构信息

University Medical Center Rostock, Department of Urology, Rostock.

St. Antonius Hospital Eschweiler, Department of Urology, Eschweiler.

出版信息

Curr Opin Urol. 2021 Jul 1;31(4):285-290. doi: 10.1097/MOU.0000000000000897.

Abstract

PURPOSE OF REVIEW

To give an overview of the significance as well as recent developments in antibiotic stewardship (ABS) in urology and for the treatment of urinary tract infections (UTI). This rapid review is focused on recent publications during the past 18 months.

RECENT FINDINGS

Despite the evidence to support the use of ABS interventions in the treatment of UTIs, there remains considerable inappropriate use of antibiotics, up to 68%, especially concerning the treatment of asymptomatic bacteriuria and the overuse of fluoroquinolones. Emerging evidence indicate that ABS programs can improve patient outcome and reduce multidrug-resistant pathogens.Interestingly, in this past 18 months new targets for ABS have been developed, e.g. involvement of a pharmacist, strict adherence to guidelines, improvement of the guidelines itself and understanding the prescription process in the emergency room as well as the analysis of own surveillance data.

SUMMARY

ABS programs in urology are essential and their significance has become more apparent than ever before. New targets for ABS interventions should be evaluated in prospective controlled clinical trials of their effectiveness to reduce further inappropriate antibiotic use without hindering the treatment of UTIs.

摘要

目的综述

介绍泌尿外科抗生素管理(ABSM)以及治疗尿路感染(UTI)的重要性和最新进展。这篇快速综述重点关注过去 18 个月的最新出版物。

最近发现

尽管有证据支持 ABS 干预措施在治疗 UTI 中的应用,但抗生素的使用仍存在相当大的不合理性,高达 68%,特别是在无症状菌尿和氟喹诺酮类药物的过度使用方面。新出现的证据表明,ABSM 方案可以改善患者的预后并减少多药耐药病原体。有趣的是,在过去的 18 个月中,已经开发出了 ABS 的新目标,例如药剂师的参与、严格遵守指南、改进指南本身以及了解急诊室的处方过程以及分析自身监测数据。

总结

泌尿外科的 ABSM 方案至关重要,其重要性比以往任何时候都更加明显。应该在前瞻性对照临床试验中评估 ABS 干预措施的新目标,以减少进一步的不合理抗生素使用,同时不影响 UTI 的治疗。

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