Global Antimicrobial Stewardship: Challenges and Successes from Frontline Stewards.
Global Antimicrobial Stewardship: Challenges and Successes from Frontline Stewards.
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全球抗菌药物管理：一线管理人员的挑战和成功。
DOI：
10.1007/s40121-015-0088-4
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发表时间：
2015
影响因子：
5.4
通讯作者：
Rybak,MichaelJ
中科院分区：
文献类型：
--
作者：
Goff,DebraA;Rybak,MichaelJ
当前全球抗菌药物的过度使用和滥用需要国际社会采取紧急应对措施。根据 2014 年世界卫生组织 (WHO) 抗生素耐药性全球监测报告，美国每年因抗生素耐药性死亡的人数高达 23,000 人，欧盟为 25,000 人，泰国为 38,000 人，印度为 58,000 人[1]。世界卫生组织于 2015 年 5 月制定了一项全球行动计划，要求成员国制定国家战略计划，通过建立全球发展和抗生素管理框架来应对抗菌素耐药性[2]。许多国家已在医院环境中成功实施了抗菌药物管理计划，而一些资源有限的国家仍在努力建立和运行管理计划。抗菌管理艺术 (AMS) 是一门不断发展的学科。本期主题文章旨在为读者提供 6 个不同国家成功的抗菌药物管理计划的概述；美国、英国、南非、新加坡、澳大利亚和意大利。作者讨论了药剂师在 AMS 中的国际作用。本期包括来自南非和新加坡的两项研究以及四项对管理工作的审查，并描述了药剂师的角色。这个问题始于 Messina 等人的一项研究。来自资源有限的国家南非。这项由药剂师主导的前瞻性多中心研究旨在改善抗生素的“滞留时间”，其定义为从书面抗生素医嘱到实际静脉注射所经过的时间。来自 33 家医院的药剂师在 60 周的研究期间对 32,985 名患者进行了评估和干预，并将“挂起时间依从性”从 41.2% 显着提高到 78.4%。此次活动的成功
The current global overuse and misuse of antimicrobials requires an urgent international response. According to the 2014 World Health Organization (WHO) Antimicrobial Resistance Global Report on Surveillance, deaths per year due to antibiotic resistance are reported as high as 23,000 in the United States, 25,000 in the European Union, 38,000 in Thailand and 58,000 in India [1]. The WHO developed a Global Action Plan in May 2015 mandating member states to produce national strategic plans to combat antimicrobial resistance by establishing a global development and antibiotic stewardship framework [2]. Many countries have successfully implemented antimicrobial stewardship programs in the hospital setting while several limited resource countries continue to struggle with getting stewardship programs up and running. The art of antimicrobial stewardship (AMS) is an evolving discipline. The articles in this themed issue aim to provide the reader with an overview of successful antimicrobial stewardship programs from 6 different countries; the United States, United Kingdom, South Africa, Singapore, Australia, and Italy. The authors discuss the international role of pharmacists in AMS. Included in this issue are two studies from South Africa and Singapore and four reviews of stewardship efforts with a description of the pharmacist’s role. The issue starts with a study by Messina et al. from South Africa, a resource-limited country. This prospective multi-center pharmacist-driven study aimed to improve the ‘‘hangtime’’of antibiotics defined as the time elapsed from the written antibiotic order to actual intravenous administration. Pharmacists from 33 hospitals evaluated and intervened on 32,985 patients over a 60-week study period and significantly improved ‘‘hangtime compliance from 41.2% to 78.4%. The success of this