Antimicrobial Stewardship in China: Systems, Actions and Future Strategies
Antimicrobial Stewardship in China: Systems, Actions and Future Strategies
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DOI：
10.1093/cid/ciy641
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发表时间：
2018-12-01
影响因子：
11.8
通讯作者：
Xiao, Yonghong
中科院分区：
文献类型：
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作者：
Xiao, Yonghong
抗菌素耐药性(AMR)已成为严重的全球公共卫生危机，控制AMR已成为各国的当务之急。具体地说，各种常见的多药耐药菌发生率高，不合理使用抗菌药物存在多重问题。在过去的十年里，中国建立了较为完善的抗菌药物监管管理体系和技术支撑框架，包括法规、指南、抗菌药物使用和抗菌药物使用监测网络以及专业人员培训。此外，卫生部还开展了一项专项活动，促进医疗机构正确使用抗生素，显著改善了结果。无适应症抗菌药物的使用和抗生素的消耗明显减少。考虑到影响药品不良反应的因素、中国医疗体系的结构以及控制药品不良反应需要长期持续的努力，遏制药品不良反应必须实施“两步走、两手抓”的战略。第一步是普遍促进抗菌药物的合理使用，以便在政府的高压下及时遏制耐药性的上升势头。第二步需要可持续的专业工作，实施精确的AMR控制。“一手”是指以政府为主导，积极建立和优化合理使用抗生素和AMR控制的制度和基础设施。“秒手”指的是培养专业团队，确保AMR管控中可持续流程的建立和发展。
Antimicrobial resistance (AMR) has become a serious global public health crisis, and AMR control has consequently become a priority in all countries. Specifically, the incidence of various common multidrug-resistant bacteria is high, and there are multiple problems concerning the irrational use of antimicrobial drugs. In the past decade, China has established a relatively comprehensive management system and technical support framework for antimicrobial stewardship, including regulations, guidelines, networks for the surveillance of AMR and antimicrobial consumption, and professional personnel training. In addition, the Ministry of Health has carried out a special campaign to promote the proper clinical use of antibiotics in medical institutions, which significantly improved outcomes. The use of antibacterial drugs without indication and the consumption of antibiotics have been significantly reduced. In consideration of the factors that contribute to AMR, the structure of the healthcare system in China, and the need for long-term sustaining efforts to control AMR, the strategy of "two steps and two hands" must be implemented to contain AMR. The first step is to generally promote the rational use of antimicrobial agents in order to promptly curb the rising momentum of resistance with high pressure from the government. The second step requires sustainable professional work with the implementation of precise AMR control. The "first hand" refers to the government-oriented active establishment and optimization of the system and infrastructure of rational antibiotic use and AMR control. The "second hand" refers to the cultivation of professional teams to ensure the establishment and development of sustainable processes in AMR control.