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本文引用的文献

1
Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods.抗菌药物敏感性试验:当前使用方法的全面综述
Antibiotics (Basel). 2022 Mar 23;11(4):427. doi: 10.3390/antibiotics11040427.
2
Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries.提高抗菌药物使用的策略,特别关注发展中国家
Life (Basel). 2021 Jun 7;11(6):528. doi: 10.3390/life11060528.
3
Challenges in Implementing Antimicrobial Stewardship Programmes at Secondary Level Hospitals in India: An Exploratory Study.印度二级医院实施抗菌药物管理计划面临的挑战:一项探索性研究
Front Public Health. 2020 Sep 18;8:493904. doi: 10.3389/fpubh.2020.493904. eCollection 2020.
4
Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery.低收入和中等收入国家的抗生素使用与外科手术中的抗微生物药物耐药性挑战
Antibiotics (Basel). 2020 Aug 9;9(8):497. doi: 10.3390/antibiotics9080497.
5
The Role of Antibiotic Stewardship in Promoting Appropriate Antibiotic Use.抗生素管理在促进合理使用抗生素中的作用。
Am J Lifestyle Med. 2017 Apr 4;13(4):376-383. doi: 10.1177/1559827617700824. eCollection 2019 Jul-Aug.
6
Microbial and Antibiotic Susceptibility Profile among Isolates of Clinical Samples of Cancer Patients Admitted in the Intensive Care Unit at Regional Tertiary Care Cancer Center: A Retrospective Observational Study.地区三级护理癌症中心重症监护病房收治的癌症患者临床样本分离株中的微生物及抗生素敏感性分析:一项回顾性观察研究
Indian J Crit Care Med. 2019 Feb;23(2):67-72. doi: 10.5005/jp-journals-10071-23119.
7
Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study.抗生素治疗对脓毒症早期血培养阳性率的影响:一项前瞻性临床队列研究。
Clin Microbiol Infect. 2019 Mar;25(3):326-331. doi: 10.1016/j.cmi.2018.05.016. Epub 2018 Jun 4.
8
Antimicrobial stewardship programme (AMSP) practices in India.印度的抗菌药物管理计划(AMSP)实践。
Indian J Med Res. 2015 Aug;142(2):130-8. doi: 10.4103/0971-5916.164228.
9
Financial evaluations of antibiotic stewardship programs-a systematic review.抗生素管理项目的财务评估:系统评价。
Front Microbiol. 2015 Apr 16;6:317. doi: 10.3389/fmicb.2015.00317. eCollection 2015.
10
Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.抗菌药物耐药性:抗生素过度使用相关风险及解决措施。
Ther Adv Drug Saf. 2014 Dec;5(6):229-41. doi: 10.1177/2042098614554919.

文化的培养:迈向增强诊断管理的一小步。

Culture of Cultures: A Small Step Towards Augmenting Diagnostic Stewardship.

作者信息

Cheemalapati Shashank, R Deepashree, S R Sujatha, Karthik M V S Krishna, D Narayanappa

机构信息

Department of General Medicine, JSS Medical College and Hospital, Mysore, IND.

Department of Microbiology, JSS Medical College and Hospital, Mysore, IND.

出版信息

Cureus. 2024 Jun 29;16(6):e63451. doi: 10.7759/cureus.63451. eCollection 2024 Jun.

DOI:10.7759/cureus.63451
PMID:39077235
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11285012/
Abstract

Laboratories with a well-established diagnostic stewardship program for culture and the antimicrobial susceptibility test (C-AST) play a key role in guiding clinicians to institute specific targeted therapy. Blood culture is one of the most critical investigations performed at a microbiology laboratory. Therefore, it is particularly important to develop a robust diagnostic stewardship model for the blood culture laboratory division. Aiming at this hypothesis, this hospital-based clinical audit carried out within the Department of General Medicine, centered on the critical domain of antimicrobial stewardship (AMSP). The audit's primary objective was to systematically evaluate prevailing practices and pinpoint areas necessitating refinement in the administration of antimicrobial agents. Employing a meticulous approach involving exhaustive data scrutiny and feedback mechanisms, the audit unearthed strategic opportunities to optimize prescription patterns, curtail unwarranted antimicrobial utilization, and fortify adherence to established guidelines. The subsequent execution of targeted interventions, encompassing educational initiatives and routine performance feedback, culminated in a noteworthy enhancement of antimicrobial prescribing practices. These outcomes unequivocally underscore the efficacy of the audit in cultivating a milieu of judicious antimicrobial utilization, thereby augmenting patient care and mitigating antibiotic resistance within the department.

摘要

拥有完善的培养及抗菌药物敏感性试验(C-AST)诊断管理计划的实验室,在指导临床医生制定特定的靶向治疗方案方面发挥着关键作用。血培养是微生物实验室进行的最关键检查之一。因此,为血培养实验室部门建立一个强大的诊断管理模型尤为重要。基于这一假设,该以医院为基础的临床审计在普通内科开展,以抗菌药物管理(AMSP)的关键领域为中心。审计的主要目标是系统评估现行做法,并找出抗菌药物管理方面需要改进的领域。通过采用细致入微的方法,包括详尽的数据审查和反馈机制,审计发现了优化处方模式、减少不必要的抗菌药物使用以及加强对既定指南的遵守的战略机会。随后实施的有针对性的干预措施,包括教育举措和常规绩效反馈,最终显著改善了抗菌药物处方做法。这些结果明确强调了审计在营造明智使用抗菌药物环境方面的成效,从而改善了科室的患者护理并减轻了抗生素耐药性。