Rapid diagnostics and appropriate antibiotic use.
Rapid diagnostics and appropriate antibiotic use.
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DOI：
10.1093/cid/cir051
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发表时间：
2011-05
期刊：
影响因子：
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通讯作者：
L. Rice
中科院分区：
文献类型：
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作者：
L. Rice
大多数抗生素是由缺乏传染病研究生培训的医生开的。因此，处方医生在考虑如何使用分子和微生物学数据来告知治疗选择方面具有不同程度的兴趣和复杂性。因此，旨在修改医生抗菌药物处方实践的策略必须选择简单而不是复杂，并且必须承认我们对许多抗菌药物-微生物相互作用的细节的基本无知。他们还必须认识到住院患者细菌性疾病的严重性，以及在疾病早期提供有效抗菌治疗的重要性。在规定的时间间隔内评估治疗的“后端”策略比在疾病早期限制医生选择的策略更容易被接受。因此，至关重要的是，我们开发快速和可靠的微生物检测，循证建议适当的治疗时间，并准确的替代标志物的感染解决。
Most antibiotics are prescribed by physicians lacking postgraduate training in infectious diseases. As such, prescribing physicians have varying levels of interest and sophistication in thinking about how to use molecular and microbiological data to inform therapeutic choices. Strategies designed to modify physician antimicrobial-prescribing practices must therefore choose simplicity over complexity and must acknowledge our fundamental ignorance of many of the specifics of antibiotic-microorganism interactions. They must also acknowledge the critical nature of bacterial illnesses in hospitalized patients and the importance of delivering effective antimicrobial therapy early in the illness. "Back-end" strategies that evaluate therapy at defined intervals will be more readily accepted than strategies limiting physician choices early in the illness. It is therefore critical that we develop rapid and reliable microbiological assays, evidence-based recommendations on appropriate durations of therapy, and accurate surrogate markers of infection resolution.