重症监护病房内的抗菌药物管理实践进展

Progress in antimicrobial stewardship in intensive care units

抗菌药物管理(antimicrobial stewardship,AMS)是控制细菌耐药的重要手段,重症监护病房(intensive care unit,ICU)的独特情况对AMS提出了挑战。该文回顾了近年来国内外有关ICU内AMS的文献,总结了AMS相关措施。ICU内有效的AMS措施包括组建多学科AMS团队,使用微生物快速诊断技术缩短诊断时间,对于疑似脓毒症患者采用非培养方法评估抗菌治疗必要性,并在抗菌治疗后及早评估使用效果并优化等。这些举措旨在提高ICU内抗菌药物的合理使用,降低多重耐药菌感染风险,改善患者病情。

Antimicrobial stewardship(AMS)is an important means to control bacterial resistance.The unique situation of intensive care unit(ICU)poses a challenge to AMS.This article reviews the literature on AMS in the ICU at home and abroad in recent years,and summarizes the related measures of AMS.Effective AMS measures in the ICU include setting up a multidisciplinary AMS team,using rapid microbial diagnosis technology to shorten the time of diagnosis,using non-culture methods to assess the necessity of antimicrobial therapy for patients with suspected sepsis,and evaluating the effectiveness of antimicrobial therapy as early as possible and optimizing it.These initiatives aim to increase the rational use of antimicrobials in ICU,reduce the risk of multidrug-resistant infections,and improve patients’condition.