Granato P A
Department of Pathology, Crouse Irving Memorial Hospital, Syracuse, NY 13210.
Diagn Microbiol Infect Dis. 1993 Mar-Apr;16(3):237-43. doi: 10.1016/0732-8893(93)90116-o.
Within the last decade, major technologic advances have been made in clinical microbiology that have resulted in the availability of a wide variety of different methods for the rapid reporting of test results. Included among these technologies are rapid methods for producing antimicrobial susceptibility reports that many regard as the most important information generated by the microbiology laboratory. Ideally, the early availability of this important information should favorably affect patient care by enabling the more judicious use of alternative drug therapies that are equally efficacious yet less toxic and less costly to the patient. Clinicians appear to have been reluctant to modify initial empiric therapies, however, despite the availability of the rapid antimicrobial susceptibility report. This article addresses some of the issues responsible for this long-standing problem and discusses and explores various strategies that can be implemented for improving the use and for controlling the cost of antimicrobial agents within the hospital.
在过去十年中,临床微生物学取得了重大技术进步,从而产生了各种各样不同的方法来快速报告检测结果。这些技术包括用于生成抗菌药物敏感性报告的快速方法,许多人认为这是微生物实验室产生的最重要信息。理想情况下,这些重要信息的尽早获得应通过使人们能够更明智地使用同样有效但对患者毒性更小、成本更低的替代药物疗法,从而对患者护理产生积极影响。然而,尽管有快速抗菌药物敏感性报告,临床医生似乎仍不愿修改初始经验性治疗方案。本文探讨了造成这一长期问题的一些原因,并讨论和探索了各种可实施的策略,以改善医院内抗菌药物的使用并控制其成本。