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