Blackburn Joanna, Ousey Karen, Rippon Mark, Rogers Alan, Pastar Irena, Lev-Tov Hadar
Institute of Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
Wound Care, Monash University, Melbourne, Australia.
Int Wound J. 2025 Jun;22(6):e70684. doi: 10.1111/iwj.70684.
Antimicrobial resistance is increasing due to an overreliance on antimicrobials to treat and manage infections. Chronic wounds are particularly vulnerable to infections and harbour complex microbial communities, increasing the risk of secondary infections caused by antimicrobial resistant bacteria. Accurate and early diagnosis of infection ensures appropriate treatment interventions and a reduction in the likelihood that antibiotic use is required. Despite this, the overuse of antibiotic treatment in wound care is still evident. Antimicrobial stewardship describes a structured approach to managing antimicrobial resistance through educating healthcare professionals about antimicrobial use to improve patient outcomes and minimise the spread of infections. However, the evidence suggests that healthcare professionals experience barriers when attempting to implement such strategies in their practice. It is essential that the principles of antimicrobial stewardship are embedded into wound care treatment and management. This review aimed to explore the current barriers to antimicrobial stewardship in wound care clinical practice and discuss the strategies that can be applied to successfully maximise infection prevention. There is a need to further educate wound care practitioners about antimicrobial stewardship and future research should concentrate on understanding how healthcare professionals can work collaboratively to implement such strategies in their practice.
由于过度依赖抗菌药物来治疗和管理感染，抗菌药物耐药性正在增加。慢性伤口特别容易受到感染，并且含有复杂的微生物群落，这增加了由抗菌药物耐药菌引起的继发性感染的风险。准确和早期诊断感染可确保采取适当的治疗干预措施，并降低需要使用抗生素的可能性。尽管如此，在伤口护理中抗生素治疗的过度使用仍然很明显。抗菌药物管理描述了一种通过教育医疗保健专业人员关于抗菌药物的使用来管理抗菌药物耐药性的结构化方法，以改善患者预后并尽量减少感染的传播。然而，证据表明，医疗保健专业人员在试图在实践中实施此类策略时会遇到障碍。将抗菌药物管理原则纳入伤口护理治疗和管理至关重要。本综述旨在探讨伤口护理临床实践中抗菌药物管理的当前障碍，并讨论可应用于成功最大限度预防感染的策略。有必要进一步教育伤口护理从业者关于抗菌药物管理，未来的研究应集中在了解医疗保健专业人员如何合作在实践中实施此类策略。
