合理应用抗菌药物减少院内细菌感染

感染性疾病是严重危害人体生命与健康的疾病,也是多种器官疾病晚期的主要并发症和致死原因之一。近年来,抗菌药物在防治感染性疾病中发挥了重大作用。但由于抗菌药物种类的增多,在增加防治疾病的同时,抗菌药物逐渐被滥用。随着抗菌药物的长期、广泛和不合理使用,出现了细菌的耐药菌株增多等系列问题。为了在抗感染治疗的用药过程中达到安全、有效、方便、经济的目的 ,减少院内感染的发生,抗菌药物的合理选择是非常重要的。下面就如何合理应用抗菌药物,减少院内感染的发生做一综述。     

简述抗菌药物的临床应用管理

<正>抗菌药物是治疗细菌、支原体、衣原体、立克次体、螺旋体、病毒、真菌等病原微生物所致感染性疾病病原的药物。抗菌药物不合理使用和细菌耐药问题已成为当今全球严重的公共卫生问题之一,引起各国和全社会的高度重视。根据党和政府制定的有关法规文件,结合我国医院使用抗菌药物的现状,笔者就加强抗菌药物的临床应用管理作一简述,以促进临床合理使用抗菌药物。     

基层医院使用抗生素的误区和对策

随着制药工业的飞速发展，特别是抗菌药物相继开发了许多新品种和新剂型，抗菌药物在控制细菌感染性疾病及降低疾病死亡率方面起到了重大作用。随着抗生素的广泛使用，尤其是滥用，也给治疗带来了许多新问题，如药物的毒性反应、过敏反应、二重感染以及细菌耐药性的产生等。据统计：我国基层医院使用抗生素的比例可能高达50％，     

抗菌药物的管理和合理使用

目的抗菌药物管理政策出台,标志着我国抗菌药物临床应用管理迈入法制化、制度化轨道。为逐步建立抗菌药物临床应用管理长效机制奠定了基础。方法认真学习总结有关抗菌药物管理使用有关法规。结果加强抗菌药物管理使用,控制细菌耐药。结论合理使用抗生素,提升感染性疾病的治疗水平,是更有效治疗疾病、保障广大人民群众健康权益,也是落实深化医药卫生体制改革任务的重要内容。     

抗菌药物应用管理存在问题及对策

探讨抗菌药物应用管理和细菌耐药性有效防控的途径和方法.分析抗菌药物滥用与细菌耐药性泛滥日趋恶化及管理失能防不胜防的原因.医院统管、医师自由使用所有种类的抗菌药物是其使用混乱的主要症结;忽视整体管理,产、销、用各环节自成体系是矛盾产生和难于解决的根源.建立药物监管与感染防控中心,依据细菌耐药性消长规律构建策略性"同步循环用药"体系,完善生产、配送、使用一体化管理机制,可望从根本上理顺抗菌药物管理和有效防治细菌耐药.     

抗菌药物专项整治期间我院抗菌药物使用情况分析

<正>我国抗菌药物临床使用存在使用率高、用药起点高、无指征应用普遍、细菌耐药率持续增长等特点,当前抗菌药物不合理使用率已经超过60%[1-3]。为进一步加强医疗机构抗菌药物临床应用管理,促进抗菌药物合理使用,有效控制细菌耐药,保证医疗质量和医疗安全,原卫生部决定自2011—2013年,在全国范围内开展抗菌药物临床     

门急诊抗菌药物处方点评及合理应用管理措施

<正>抗菌药物在临床多种疾病的治疗中有着广泛的应用,尤其在治疗多种感染性疾病方面具有显著的疗效。抗菌药物合理使用能够提高抗感染疗效,降低药品不良反应的发生率和延缓细菌的耐药性[1,2]。然而,人们过于频繁地使用这类药物,甚至在不需要的时候也使用,就会导致抗菌药物耐药[3]。为规范抗菌药物的管理,促进抗菌药物合理使用,有效控制细菌耐药,保证医疗质量和医疗安全,我国相继颁布了一系列的法律法规来规范抗菌药物的临床应用。目前各级医院均在积极进行抗菌药物处方点评,并形成了适合各自医院的处方点评模     

处方分析——谈抗菌药物的合理应用

抗菌药物的临床使用，在治疗细菌性感染的疾病中取得了可喜的成绩；但随着新抗菌药物不断涌现和抗菌药物的广泛使用，也带来了许多新问题。如抗菌药物的选择不当和滥用，联合用药中出现的配伍不当及细菌抗药性的产生等．为了合理使用抗菌药物，防止和减少上述情况的发生，通过对1000张使用抗菌药物的住院处方进行分析．从而探讨抗菌药物的合理使用原则。     

抗菌药物的发展及其细菌耐药性

抗菌药物的发展史,也是细菌对其耐药性的发展史,伴随抗菌药物强大的抗感染疗效的同时,细菌对抗菌药物产生耐药。随着我国经济的快速发展,抗菌药物的生产和使用得到拓展,人民健康情况得到明显改善,但抗菌药物的临床应用,包括预防、治疗两方面的使用失控,使细菌耐药性迅速产生,如喹诺酮类药物,1986年在我国上市以后,同类新药迅速发展,近年其耐药率迅速升高,西方发达国家此类药比我国早上市3年,但是细菌耐药性情况却没有我国严重。“滥用抗菌药物将使人类回到无抗菌药物的时代”,这是世界卫生组织发出的警告。1抗菌药物的发展,伴随细菌耐药性青…     

促进抗菌药物的临床合理应用

抗菌药物广泛应用于各种感染性疾病,虽然抗菌药物能很好地预防和治疗疾病,不过其不良反应我们也不容忽视,这迫使我们必须更合理地使用抗菌药物.合理使用抗菌药物应根据抗菌药物临床应用的基本原则,在提高抗菌药物的同时尽量降低其不良反应的发生以及减少或减缓细菌耐药性的发生,同时我们必须加强抗菌药物临床应用的管理和查察工作,从而更安全、有效、经济地应用抗菌药物来治疗疾病.     

Use of macrocyclic lactones in cattle in the USA

The use of macrocyclic lactones has become the main stay for the treatment of endo- and ectoparasites in the cattle industry. Here we review those drugs that are currently approved for use in cattle in the United States. The general efficacy, tissue distribution and toxicity of each drug formulation are discussed. Included is a discussion regarding the current status for nematode anthelmintic resistance in cattle populations within the United States. Also provided is a current summary of ecological effects of macrocyclic lactones residues in manure.     

氨基糖苷类等抗菌药物的个体化治疗应用

合理使用抗菌药物不仅能有力保护人类珍贵的药物资源，而且可促进感染病患者的规范诊治与健康。患者之间、病原菌之间、感染病之间及抗菌药物之间均存在明显差异，抗菌药物个体化治疗是合理用药的必由之路，关注感染病诊治中的人体、病原体、疾病与药物是个体化治疗的关键，值得临床高度重视。     

Cephalosporins in veterinary medicine - ceftiofur use in food animals

Cephalosporins are an important class of antibacterial agents in use today for both humans and animals. Four generations of cephalosporins have evolved, all of which contain the beta-lactam sub-structure first found in penicillin. The range of cephalosporins available for use in food-producing animals, which is the subject of this review, is limited compared to humans. A few first- and second-generation cephalosporins are approved worldwide strictly for treatment of mastitis infections in dairy cattle. A third-generation cephalosporin, ceftiofur, and a fourth-generation cephalosporin, cefquinome, have been developed strictly for veterinary use. Cefquinome has been approved in several countries for the treatment of respiratory disease in cattle and swine, foot rot in cattle and for mastitis in dairy cattle. Ceftiofur has worldwide approvals for respiratory disease in swine, ruminants (cattle, sheep and goats) and horses and has also been approved for foot rot and metritis infections in cattle. Ceftiofur has also been approved in various countries for early mortality infections in day-old chicks and turkey poults. This review summarizes cephalosporin use in general terms, and provides an overview of ceftiofur, in terms of its spectrum of activity, indications, metabolism, and degradation in the environment. The safety of ceftiofur is also reviewed, with respect to food-animal residues, rapid metabolism and degradation, and non-persistence of ceftiofur in the environment. The environmental fragility of cephalosporins have not been explored generally, but may be an important characteristic of this antibiotic class with respect to safety of use in animals.     

Intraoral delivery of antimicrobials

Antimicrobial therapies for oral diseases have been in use for centuries, but have undergone rapid changes in the last decade. In the coming years, antimicrobial strategies will become more sophisticated and efficacy will be greatly improved as new therapeutic technologies emerge. New delivery systems for common antimicrobials and novel agents to modulate the immune system, as well as biofilm formation and maturation, may be on the horizon. This review describes the development and the application of intraoral antimicrobial drug delivery in the oral environment. Current clinical uses of antimicrobials as well as future approaches to the treatment and prevention of oral infectious diseases are discussed.     

兽用抗菌药耐药判定标准的研究进展

兽用抗菌药因其可以有效地预防和治疗动物疾病而被广泛使用，造成了严重的细菌耐药。目前，兽药抗菌药的耐药判定主要参考美国临床和实验室标准协会(CLSI)和欧盟药敏试验标准委员会(EUCAST)公布的标准，但数据并不完整。我国近些年也开始建立适合自己国情的兽用抗菌药的耐药判定标准，但成果并不多。因此，急需建立和完善兽用抗菌药的耐药判定标准，以便于监测兽用抗菌药耐药性和指导临床准确使用兽用抗菌药。本文主要综述了CLSI和EUCAST两大组织已经公布的部分兽用抗菌药的耐药判定标准，以及近年来国内外兽用抗菌药耐药判定标准的研究进展，以期为兽用抗菌药耐药判定标准的发展提供理论参考。     

国内抗菌药物应用现状及实施抗菌药物合理应用干预的可行性与难点

目的 :探究实施抗菌药物合理应用干预的可行性与难点。方法 :根据国内抗菌药物应用的实际情况 ,分析有无不合理使用现象及是否有必要对抗菌药物临床合理应用进行干预。结果 :国内抗菌药物在临床应用过程中使用频率过高 ,围手术期抗菌药物使用范围广、时间长、起点高 ,存在抗菌药物选择不合理及忽视特殊群体用药等问题 ,导致耐药菌增多、毒副反应增加。结论 :推行《抗菌药物临床应用指导原则》 ,实施抗菌药物合理应用干预具有必要性和可行性 ,但也存在一定难点。     

Evolving importance of biologics and novel delivery systems in the face of microbial resistance

Methods to control infectious diseases in livestock are growing in importance. As the size of the average farm increases-for poultry, dairy and beef cattle, swine, and fish-the risk of rapid spread of infectious diseases increases as well. This increases the need for alternative methods of control of infectious agents. Improvements in specific immunogens, adjuvants, and delivery systems are needed to meet the demand for vaccines to ensure a healthy and safe meat supply. This article explores the challenges, trends, and recent advances in the control of infectious diseases through the use of biologics.     

iPhones, iPads, and medical applications for antimicrobial stewardship

One of the most important antimicrobial stewardship activities of the infectious diseases pharmacist and physician is to provide education and clinical information about antimicrobials to health care professionals and patients; however, clinician training and continuing education in appropriate antimicrobial use in the United States are highly variable and nonstandardized. The iPhone, iPad, and the availability of more than 12,000 medical applications (referred to as "apps") allow stewardship programs the ability to integrate novel technology with point-of-care education. This article reviews medical apps for antimicrobial stewardship programs to use on the iPhone or iPad.     

Rare diseases, orphan drugs and their regulation: questions and misconceptions

Sustained advocacy efforts driven by patients' organizations to make rare diseases a health priority have led to regulatory and economic incentives for industry to develop drugs for these diseases, known as orphan drugs. These incentives, enacted in regulations first introduced in the United States in 1983 and later in Japan, Europe and elsewhere, have resulted in substantial improvements in the treatment for patients with a range of rare diseases. However, the advent of orphan drug development has also triggered several questions, from the definition of rarity to the pricing of orphan drugs and their impact on health-care systems. This article provides an industry perspective on some of the common questions and misconceptions related to orphan drug development and its regulation, with the aim of facilitating future progress in the field.     

某院2009～2011年细菌耐药率变化与抗菌药物使用量关系的研究

目的了解2009年1月～2011年12月笔者所在医院医院感染常见病原菌的耐药变化趋势及抗菌药物使用量,探讨抗菌药物使用量与病原菌耐药率之间的相关性。方法对3年间13种抗菌药物使用量与医院感染常见病原菌对目标抗菌药物耐药率进行统计分析,计算各药的用药频度,对耐药率与DDDs进行相关性分析。结果 3年期间病原菌耐药率逐步上升,期间笔者所在医院有9种抗菌药物DDDs的变化与治疗目标菌的耐药率变迁呈显著相关。结论抗菌药物的广泛使用或使用不当与加速细菌耐药的产生和发展可能有着密切联系,规范抗菌药物的使用对延缓细菌耐药性的发展有着重要意义。