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Antimicrobial Stewardship: The Need to Cover All Bases

机译：抗菌素管理：涵盖所有基础的需求

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Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections forces clinicians to change those behaviors that drive antimicrobial resistance. The majority of antimicrobial stewardship (AMS) programs function in acute-care hospitals, however, hospitals are only one setting where antibiotics are prescribed. Antimicrobial use is also high in residential aged care facilities and in the community. Prescribing in aged care is influenced by the fact that elderly residents have lowered immunity, are susceptible to infection and are frequently colonized with multi-resistant organisms. While in the community, prescribers are faced with public misconceptions about the effectiveness of antibiotics for many upper respiratory tract illnesses. AMS programs in all of these locations must be sustainable over a long period of time in order to be effective. A future with effective antimicrobials to treat bacterial infection will depend on AMS covering all of these bases. This review discusses AMS in acute care hospitals, aged care and the community and emphasizes that AMS is critical to patient safety and relies on government, clinician and community engagement.
机译：越来越多的抗药性已经需要一种指导抗生素使用的方法。通过管理指导抗菌药物使用的必要性从未如此紧迫。抗感染创新的下降以及当前可用的抗微生物药未能治疗某些严重感染，迫使临床医生改变那些驱动抗微生物药耐药性的行为。大多数抗菌药物管理（AMS）计划在急诊医院中起作用，但是，医院只是开处方抗生素的场所之一。住宅养老机构和社区中抗菌药物的使用也很高。老年居民的免疫力降低，易受感染并经常被多抗性微生物定植，这对老年护理的处方产生了影响。在社区中，开药者面临公众对抗生素对许多上呼吸道疾病的有效性的误解。所有这些地点的AMS计划都必须长期保持可持续性才能生效。拥有有效抗菌素治疗细菌感染的未来将取决于覆盖所有这些碱基的AMS。这篇评论讨论了急诊医院，老年护理和社区中的AMS，并强调AMS对患者安全至关重要，并依赖于政府，临床医生和社区的参与。

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