Antibiotic stewardship in the intensive care unit.

Antibiotic stewardship in the intensive care unit.
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DOI:
10.1186/s13054-014-0480-6
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发表时间:
2014-08-13
期刊:
Critical care (London, England)
影响因子:
--
通讯作者:
Chastre J
Chastre J
中科院分区:
其他
文献类型:
--
作者:
Luyt CE;Bréchot N;Trouillet JL;Chastre J

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耐抗生素微生物在全世界ICU中的迅速出现和传播构成了危机层面的问题。这一问题的根源是多方面的,但核心问题是明确的。抗生素耐药性的出现与这些药物的不适当使用造成的选择压力高度相关。ICU中适当的抗生素管理不仅包括根据药代动力学-药效学特征快速识别和优化治疗这些危重患者的细菌感染,还包括提高我们避免使用不必要的广谱抗生素的能力,缩短其给药持续时间,并减少接受不当抗生素治疗的患者数量。要么我们能够实施这样的政策,要么我们和我们的患者将面临难以控制的难以治疗的病原体激增。
The rapid emergence and dissemination of antimicrobial-resistant microorganisms in ICUs worldwide constitute a problem of crisis dimensions. The root causes of this problem are multifactorial, but the core issues are clear. The emergence of antibiotic resistance is highly correlated with selective pressure resulting from inappropriate use of these drugs. Appropriate antibiotic stewardship in ICUs includes not only rapid identification and optimal treatment of bacterial infections in these critically ill patients, based on pharmacokinetic-pharmacodynamic characteristics, but also improving our ability to avoid administering unnecessary broad-spectrum antibiotics, shortening the duration of their administration, and reducing the numbers of patients receiving undue antibiotic therapy. Either we will be able to implement such a policy or we and our patients will face an uncontrollable surge of very difficult-to-treat pathogens.
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