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应对抗生素耐药性和不当使用的药物警戒策略——一篇叙述性综述

Pharmacovigilance Strategies to Address Resistance to Antibiotics and Inappropriate Use-A Narrative Review.

作者信息

Sandes Valcieny, Figueras Albert, Lima Elisangela Costa

机构信息

Postgraduate Program in Pharmaceutical Sciences, School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho-373, Rio de Janeiro 21941-170, RJ, Brazil.

National Cancer Institute, Pr. da Cruz Vermelha-23, Rio de Janeiro 20230-130, RJ, Brazil.

出版信息

Antibiotics (Basel). 2024 May 16;13(5):457. doi: 10.3390/antibiotics13050457.

Abstract

The spread of antimicrobial resistance (AMR) is a global challenge. Close and continuous surveillance for quick detection of AMR can be difficult, especially in remote places. This narrative review focuses on the contributions of pharmacovigilance (PV) as an auxiliary tool for identifying and monitoring the ineffectiveness, resistance, and inappropriate use of antibiotics (ABs). The terms "drug ineffective", "therapeutic failure", "drug resistance", "pathogen resistance", and "multidrug resistance" were found in PV databases and dictionaries, denoting ineffectiveness. These terms cover a range of problems that should be better investigated because they are useful in warning about possible causes of AMR. "Medication errors", especially those related to dose and indication, and "Off-label use" are highlighted in the literature, suggesting inappropriate use of ABs. Hence, the included studies show that the terms of interest related to AMR and use are not only present but frequent in PV surveillance programs. This review illustrates the feasibility of using PV as a complementary tool for antimicrobial stewardship activities, especially in scenarios where other resources are scarce.

摘要

抗菌药物耐药性(AMR)的传播是一项全球性挑战。要进行密切且持续的监测以快速检测到AMR可能很困难,尤其是在偏远地区。这篇叙述性综述重点关注药物警戒(PV)作为一种辅助工具在识别和监测抗生素(ABs)无效、耐药及不当使用方面的作用。在PV数据库和词典中发现了“药物无效”“治疗失败”“耐药性”“病原体耐药性”和“多重耐药性”等表示无效的术语。这些术语涵盖了一系列应进一步调查的问题,因为它们有助于警示AMR的可能成因。文献中强调了“用药错误”,尤其是与剂量和适应症相关的错误,以及“超说明书用药”,这表明存在ABs的不当使用情况。因此,纳入的研究表明,与AMR及使用相关的关注术语不仅存在于PV监测项目中,而且很常见。本综述说明了将PV用作抗菌管理活动补充工具的可行性,尤其是在其他资源匮乏的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b55/11117530/46e3dbdfe8a1/antibiotics-13-00457-g001.jpg

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