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Antimicrobial Stewardship in the Emergency Department

机译：急诊科的抗菌管理

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The literature contains robust evidence on the positive impact of antimicrobial stewardship programs (ASP) in the inpatient setting. With national policies shifting toward provisions of quality health care, the impetus to expand ASP services becomes an important strategy for institutions. However data on stewardship initiatives in other settings are less characterized. For organizations with an established ASP team, it is rational to consider expanding these services to the emergency department (ED). The ED serves as an interface between the inpatient and community settings. It is often the first place where patients present for medical care, including for common infections. Challenges inherent to the fast-paced nature of the environment must be recognized for successful ASP implementation in the ED. Based on the current literature, a combination of strategies for initiating ASP services in the ED will be described. Furthermore, common scenarios and management approaches are proposed for respiratory tract, skin and soft tissue, and urinary tract infections. Expansion of ASP services across the health care continuum may improve patient outcomes with a potential associated decrease in health care costs while preventing adverse effects including the development of antibiotic resistance.
机译：文献中有强有力的证据表明抗菌药物管理计划（ASP）在住院患者中的积极作用。随着国家政策朝着提供高质量医疗服务的方向发展，推动ASP服务扩展的动力已成为机构的重要战略。但是，其他环境中有关管理计划的数据的特征较少。对于拥有已建立的ASP团队的组织，考虑将这些服务扩展到急诊部门（ED）是合理的。 ED是住院和社区设置之间的接口。它通常是患者就诊，包括常见感染的第一站。为了在ED中成功实施ASP，必须认识到环境快节奏性所固有的挑战。基于当前文献，将描述用于在ED中启动ASP服务的策略的组合。此外，针对呼吸道，皮肤和软组织以及泌尿道感染，提出了常见方案和管理方法。在整个医疗保健领域中扩展ASP服务可以改善患者的预后，从而可能降低医疗保健成本，同时防止包括抗生素耐药性在内的不良影响。

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