Puri Bipin, Vaishya Raju, Vaish Abhishek
Director Medical Services, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Professor & Senior Consultant Orthopaedic Surgeon, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
Med J Armed Forces India. 2025 May-Jun;81(3):247-258. doi: 10.1016/j.mjafi.2024.07.006. Epub 2024 Sep 19.
The misuse of antibiotics has led to the emergence of antimicrobial resistance (AMR), particularly threatening critically ill patients reliant on these medications. This review explores the challenges of superbugs and AMR in critical care settings and highlights potential solutions.
This narrative review used keywords like "antimicrobial resistance" and "superbugs" in PubMed, Scopus, and Google Scholar databases.
The overuse and misprescription of antibiotics contribute to developing superbugs, rendering traditional treatments ineffective in critical care. AMR in critical care leads to increased costs, extended hospital stays, and limited treatment options. Combating AMR requires a multifaceted approach, including antibiotic stewardship, research, and development of novel antibiotics and alternative therapies, and rigorous infection control measures. Public education and collaboration among stakeholders are crucial for effective strategies. Future success hinges on a paradigm shift toward antibiotic stewardship, innovation in antimicrobials, and infection control. Implementing legislation and antimicrobial stewardship (AMS) programs are necessary steps. Research gaps exist in understanding environmental factors influencing AMR. New classes of antibiotics, faster diagnostics, and optimized drug combinations are future directions. Global collaboration in research, surveillance, and policy development is paramount.
AMR poses a significant threat to critical care. This review emphasizes the need for a multifaceted approach to protect the effectiveness of critical care interventions. Addressing these challenges and exploring potential solutions can ensure effective treatment for critically ill patients.
抗生素的滥用导致了抗菌药物耐药性(AMR)的出现,尤其对依赖这些药物的重症患者构成威胁。本综述探讨了重症监护环境中超级细菌和AMR的挑战,并强调了潜在的解决方案。
本叙述性综述在PubMed、Scopus和谷歌学术数据库中使用了“抗菌药物耐药性”和“超级细菌”等关键词。
抗生素的过度使用和处方不当促成了超级细菌的产生,使传统治疗在重症监护中失效。重症监护中的AMR导致成本增加、住院时间延长和治疗选择有限。对抗AMR需要采取多方面的方法,包括抗生素管理、新型抗生素和替代疗法的研发以及严格的感染控制措施。公众教育和利益相关者之间的合作对于有效策略至关重要。未来的成功取决于向抗生素管理、抗菌药物创新和感染控制的范式转变。实施立法和抗菌药物管理(AMS)计划是必要步骤。在理解影响AMR的环境因素方面存在研究空白。新型抗生素、更快的诊断方法和优化的药物组合是未来的发展方向。在研究、监测和政策制定方面的全球合作至关重要。
AMR对重症监护构成重大威胁。本综述强调需要采取多方面的方法来保护重症监护干预措施的有效性。应对这些挑战并探索潜在的解决方案可以确保为重症患者提供有效的治疗。