厄他培南的正向细菌生态学效应

The benefit of ertapenem on hospital ecology.

抗生素耐药是一个世界性的问题,具有重大的临床和经济影响。而产生抗生素耐药性的一个重要原因是耐药菌株的选择,由于医院不合理和/或过度应用抗生素所致。控制耐药性的重要策略包括实施抗生素应用监控和审查及医院内菌株耐药趋势的监测和报告。传统的抗生素如头孢菌素类和喹诺酮类药物的使用与多重耐药革兰阴性菌、尤其是绿脓、不动和肠杆菌科菌耐药相关。因此在治疗方面,临床需要考虑在充分治疗感染的同时又不增加对细菌的选择性压力的抗生素。抗生素消耗量与耐药率关系的研究显示,厄他培南这个第Ⅰ类碳青霉烯类不会降低铜绿假单胞菌、肠杆菌属或其它革兰阴性菌对碳青霉烯类的敏感性,对医院细菌生态学有着正向的影响。

Resistance to antibiotic therapy is a worldwide problem with severe clinical and economic consequences. Among hospitalized patients, antibiotic resistance has been associated with increases in morbidity and mortality, prolonged hospitalization, and increased hospital costs. An important cause of antibiotic resistance is the selection of resistant bacterial strains as a result of inappropriate and/or excessive antibiotic prescribing in the hospital setting; important strategies to control resistance include monitoring and auditing drug use as well as surveillance and reporting of resistance patterns among hospital flora. Traditional antibiotics, such as cephalosporins and fluoroquinolones, are often linked to the emergence of multidrug-resistant gram-negative bacteria, particularly acinetobacter and pseudomonas spp, and increasingly, enterobacteriaceae. Accordingly, the treatment strategy is to think to choose an antibiotics with adequate infection control and lower resistance selection. Studies of relation between antibiotic consumption and antibiotic resistance show that ertapenem, a group 1 carbapenem,can not reduce the susceptibly of other antibiotics to pseudomonas spp, enterobacteriaceae and the others, and be benefit on hospital ecology.