Antibiotic De-Escalation
Antibiotic De-Escalation
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DOI：
10.1016/j.ccc.2010.09.009
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发表时间：
2011-01-01
影响因子：
4.3
通讯作者：
Masterton, Robert G.
中科院分区：
文献类型：
--
作者：
Masterton, Robert G.
抗生素减量是一种机制，通过这种机制，可以提供有效的初始抗生素治疗，同时避免不必要的抗生素使用，这将促进耐药性的发展。它是严重脓毒症的抗菌药物管理计划和治疗模式中的关键要素。降级的实施方案是基于第3天治疗点附近的微生物学结果;开始使用的经验性抗生素被停止或数量减少和/或谱变窄。此处提供的数据证明降级在临床上有效且适当。然而，需要进一步研究，特别是在实现充分惠益和实施工具方面。降级现在应该成为常规抗菌药物管理的一部分，尽管如何最好地做到这一点以及益处的全部广度和范围仍有待确定。
Antibiotic de-escalation is a mechanism whereby the provision of effective initial antibiotic treatment is achieved while avoiding unnecessary antibiotic use that would promote the development of resistance. It is a key element within antimicrobial stewardship programs and treatment paradigms for serious sepsis. The embodiment of de-escalation is that based on microbiology results around the day 3 therapy point; the empiric antibiotic(s) that were started are stopped or reduced in number and/or narrowed in spectrum. Data are presented here which demonstrate that de-escalation is clinically effective and appropriate. However, the need for further studies, particularly in terms of realization of full benefits as well as implementation tools, is highlighted. De-escalation ought now to form a part of routine antimicrobial management, though how best to do it and the full breadth and scope of benefits remain to be identified.