Appropriate empirical antibacterial therapy for nosocmial infections - Getting it right the first time
Appropriate empirical antibacterial therapy for nosocmial infections - Getting it right the first time
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DOI：
10.2165/00003495-200363200-00001
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发表时间：
2003-01-01
期刊：
影响因子：
11.5
通讯作者：
Kollef, MH
中科院分区：
文献类型：
--
作者：
Kollef, MH
住院患者中耐药细菌感染的增加导致更多患者接受不适当的抗菌药物治疗。这导致了一种新范式的发展，指导医院环境中严重感染患者的经验性抗菌治疗的管理。抗菌药物降级是一种利用抗菌药物的方法，它试图在提供适当的初始抗菌治疗的需要与限制抗菌药物耐药性的出现之间取得平衡。降低风险的目标是开出一种初始抗菌方案，覆盖与感染相关的最可能的细菌病原体，同时尽量减少抗菌药物耐药性的出现。一旦确定病原体及其易感性特征，通过缩小抗菌方案，并采用临床可接受的最短疗程，将抗菌药物耐药性降至最低。
The increasing presence of drug-resistant bacterial infections among hospitalised patients has resulted in greater numbers of patients receiving inappropriate antimicrobial treatment. This has led to the development of a novel paradigm guiding the administration of empirical antimicrobial therapy for patients with serious infections in the hospital setting. Antibacterial de-escalation is an approach to antibacterial utilisation that attempts to balance the need to provide appropriate, initial antibacterial treatment while limiting the emergence of antibacterial resistance. The goal of de-escalation is to prescribe an initial antibacterial regimen that will cover the most likely bacterial pathogens associated with infection while minimising the emergence of antibacterial resistance. Antibacterial resistance is minimised by narrowing the antibacterial regimen once the pathogens and their susceptibility profiles are determined, and by employing the shortest course of therapy clinically acceptable.