Schinas Georgios, Dimopoulos George, Akinosoglou Karolina
School of Medicine, University of Patras, 26504 Patras, Greece.
3rd Department of Critical Care, EVGENIDIO Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Microorganisms. 2023 Aug 31;11(9):2214. doi: 10.3390/microorganisms11092214.
Antimicrobial resistance (AMR) poses a significant global health challenge, exacerbated by the COVID-19 pandemic. Antimicrobial stewardship programs (ASPs) are crucial in managing this crisis, with diagnostic stewardship (DS) emerging as a key component. DS refers to the appropriate use of diagnostic tests to optimize patient outcomes, improve antimicrobial use, and combat multi-drug-resistant (MDR) organisms. Despite its potential, understanding and application of DS remain ambiguous in multiple respects, which, however, do not directly implicate the implementation of such initiatives. DS is particularly important for resident physicians who are often at the forefront of patient care and can significantly influence future AMR strategies. This review provides a comprehensive overview of DS, discussing its importance, potential challenges, and future directions. It emphasizes the need for resident physicians to understand DS principles and integrate them into their clinical practice from the beginning of their careers. The review also highlights the role of various stakeholders in implementing DS and the importance of continuous education and training. Ultimately, DS is not just a clinical tool but a philosophy of care, essential for a more responsive, humane, and effective healthcare system.
抗菌药物耐药性（AMR）对全球健康构成重大挑战，而新冠疫情使这一挑战更加严峻。抗菌药物管理计划（ASP）在应对这一危机中至关重要，诊断管理（DS）已成为关键组成部分。DS是指合理使用诊断检测以优化患者治疗效果、改善抗菌药物使用并对抗多重耐药（MDR）微生物。尽管DS具有潜力，但其在多个方面的理解和应用仍不明确，不过这并不直接影响此类举措的实施。DS对住院医师尤为重要，他们通常处于患者护理的前沿，能够显著影响未来的AMR策略。本综述全面概述了DS，讨论了其重要性、潜在挑战和未来方向。它强调住院医师需要从职业生涯开始就理解DS原则并将其融入临床实践。该综述还强调了各利益相关方在实施DS中的作用以及持续教育和培训的重要性。归根结底，DS不仅是一种临床工具，更是一种护理理念，对于构建更具响应性、人性化和高效的医疗体系至关重要。
