Using antibiotics responsibly: right drug, right time, right dose, right duration
Using antibiotics responsibly: right drug, right time, right dose, right duration
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DOI：
10.1093/jac/dkr370
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发表时间：
2011-11-01
影响因子：
5.2
通讯作者：
Sharland, Mike
中科院分区：
文献类型：
--
作者：
Dryden, Matthew;Johnson, Alan P.;Sharland, Mike
每个开抗生素处方的人都应该考虑他们的临床和公共卫生责任。目标应该是提供最佳的患者护理，同时寻求最大限度地减少可能导致抗生素耐药性出现和传播的选择性压力。为此目的，欧洲疾病控制中心于2008年发起了每年11月18日的欧洲提高抗生素认识日活动，在全欧洲范围内开展活动，强调谨慎开抗生素处方的极端重要性。今年在英格兰的活动将侧重于二级保健感染的最佳管理，并将有两个相互关联的目标。首先是提高最初决定开抗生素的质量（包括在知情的情况下选择经验性药物和剂量），特别是确保在假定的败血症中快速开处方和给药。根据患者的临床反应和可获得的微生物学检测结果，在48小时内对抗生素治疗进行正式审查，这一点非常重要。这应该导致一个明确的决定，停止，切换到口服，切换到门诊抗生素治疗（OPAT）或更换抗生素，如果可能的话，以较窄的频谱。英国的EAAD活动将强调“聪明地开始，然后专注”的必要性。目的是让接受抗生素治疗的患者在正确的时间、正确的剂量、正确的疗程内接受正确的药物治疗。
Everyone prescribing antibiotics should consider both their clinical and public health responsibilities. The objective should be to provide optimal patient care while at the same time seeking to minimize selective pressure that may result in the emergence and spread of antibiotic resistance. To this end, in 2008 the European Centre for Disease Control initiated the annual European Antibiotic Awareness Day (EAAD) to take place on 18 November, when Europe-wide activities are undertaken to highlight the critical importance of prudent antibiotic prescribing. This year activities in England will focus on the optimal management of infections in secondary care, and will have two inter-related aims. The first is to improve the quality of the initial decision to prescribe an antibiotic (including making an informed choice of empirical drug and dose) in particular ensuring rapid prescribing and administration in presumed sepsis. This is deliberately combined with a second focus on the critical importance of formally reviewing antibiotic therapy at 48 h, based on the patient's clinical response and the availability of microbiology test results. This should lead to a clear decision to stop, switch to oral, switch to outpatient antibiotic therapy (OPAT) or change antibiotic, if possible to a narrower spectrum. The EAAD campaign in England will highlight the need to 'Start Smart-Then Focus'. The aim is that patients receiving antibiotics should receive the right drug at the right time at the right dose for the right duration.