改善老年人护理机构中的尿路感染管理。
Improving management of urinary tract infections in residential aged care facilities.
机构信息
MBBS, FRACP, MPH, Infectious Diseases Physician, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne Health, Melbourne, Vic; Infectious Diseases Physician, The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic; Infectious Diseases Physician, Department of Infectious Diseases, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic; Infectious Diseases Physician, Aged Care Quality and Safety Commission, Melbourne, Vic.
RN, MPH, PhD, Infection Control Consultant, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre/ National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Vic; Infection Control Consultant, Department of Nursing, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Vic.
出版信息
Aust J Gen Pract. 2022 Aug;51(8):551-557. doi: 10.31128/AJGP-05-22-6413.
BACKGROUND
Antimicrobial resistance rates are higher in Australian residential aged care facilities (RACFs) than other community or hospital settings. This is driven by antibiotic overuse and misuse. Urinary tract infection (UTI) is consistently the most common infection treated with antibiotics in Australian RACFs.
OBJECTIVE
The aim of this article is to provide an overview of how general practitioners (GPs) can support appropriate UTI management in RACFs following antimicrobial stewardship (AMS) principles.
DISCUSSION
GPs are well placed to improve UTI management in RACFs. In this article, criteria for suspected, proven, recurrent and relapsed UTI are outlined, in addition to key AMS practices for the assessment, prevention, treatment and review of UTIs. Included are recommendations for the judicious use of urine dipstick testing, a widespread and longstanding practice in RACFs, and first-line empirical antibiotic prescribing for suspected UTIs.
背景
与其他社区或医院环境相比，澳大利亚的住宅养老机构（RACF）中的抗生素耐药率更高。这是由于抗生素的过度使用和滥用所致。尿路感染（UTI）一直是澳大利亚 RACF 中用抗生素治疗的最常见感染。
目的
本文旨在概述全科医生（GP）如何根据抗生素管理（AMS）原则，支持 RACF 中适当的 UTI 管理。
讨论
GP 非常适合改善 RACF 中的 UTI 管理。在本文中，概述了疑似、确诊、复发性和复发性 UTI 的标准，以及用于 UTI 的评估、预防、治疗和复查的关键 AMS 实践。包括对尿液试纸检测的合理使用的建议，这是 RACF 中广泛存在且长期存在的做法，以及疑似 UTI 的一线经验性抗生素处方。
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