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抗生素治疗时间长短对抗微生物耐药性的重要性。

The importance of antibiotic treatment duration in antimicrobial resistance.

机构信息

Clinical pharmacologist, Directorate General for Health Prevention, Italian Ministry of Health, Rome, Italy.

Department Infectious Diseases, Italian National Institute of Health, Viale Regina Elena 299, Rome, 00161, Italy.

出版信息

Eur J Clin Microbiol Infect Dis. 2024 Aug;43(8):1673-1675. doi: 10.1007/s10096-024-04867-y. Epub 2024 Jun 4.

Abstract

Antimicrobial resistance (AMR) poses a significant threat to global health, leading to increased deaths from drug-resistant infections and escalates healthcare costs. Often termed a "silent pandemic," AMR occurs when pathogens become resistant to antimicrobial drugs, enabling their proliferation and spread. Inappropriate antibiotic usage is a major contributor to this phenomenon, which also extends to fungal infections. In particular, the duration of antibiotic therapy is a crucial aspect, with evidence suggesting that prolonged use can heighten bacterial resistance and harm the human microbiota. In fact, studies comparing short-term versus long-term antibiotic therapies show no significant difference in traditional treatments. In addition, therapeutic drug monitoring allows personalized antibiotic regimens, optimizing dosage and duration to minimize resistance and adverse effects. As a result, clinicians should regularly reassess treatment effectiveness, utilizing techniques like antibiotic timeout and de-escalation therapy to avoid prolonged antibiotic use and mitigate resistance. All these strategies are crucial to prevent and counter the phenomenon of antimicrobial resistance.

摘要

抗菌药物耐药性(AMR)对全球健康构成重大威胁,导致耐药感染导致的死亡人数增加,并推高了医疗保健成本。这种现象通常被称为“无声的大流行”,当病原体对抗菌药物产生耐药性时,就会发生 AMR,从而使其能够增殖和传播。抗生素的不当使用是造成这种现象的主要原因,它也延伸到了真菌感染。特别是,抗生素治疗的持续时间是一个关键方面,有证据表明,长期使用会增加细菌耐药性并损害人类微生物群。事实上,比较短期和长期抗生素治疗的研究表明,传统治疗方法没有显著差异。此外,治疗药物监测可实现个体化的抗生素治疗方案,优化剂量和持续时间,以最大程度地减少耐药性和不良反应。因此,临床医生应定期重新评估治疗效果,采用抗生素暂停和降级治疗等技术,避免长期使用抗生素并减轻耐药性。所有这些策略对于预防和对抗抗菌药物耐药性现象都至关重要。

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