关注抗菌药耐药性感染--我们是否只见树木不见森林,只见病原体不见患者?

Alexander Lawandi, S. Kadri, John H. Powers
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引用次数: 0

摘要

抗菌药耐药性(AMR)是一项挑战,因为它与患者的不良预后有关。要解决这一问题,就必须制定干预措施和政策,通过延长存活时间、改善患者症状、功能和生活质量来改善患者预后。从逻辑上讲,我们应该将资源集中用于对公共健康影响最大的领域。AMR 采取的方法是关注单个病原体和 "以病原体为重点 "的发展。然而,对整体感染及其对患者预后的影响进行评估后发现,18 例感染死亡病例中有 17 例与易感病原体有关。在此,我们讨论了重新关注患者和患者预后而非病原体的问题,并就关注患者如何影响临床研究的领域和激励机制提出了六点建议。
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Focusing on antimicrobial resistant infections –are we missing the forest for the trees and the patients for pathogens?
Antimicrobial resistance (AMR) is a challenge because it is associated with worse patient outcomes. To solve the problem will take development of interventions and policies which improve patient outcomes by prolonging survival, improving patient symptoms, function and quality of life. Logically, we should look to focusing resources in areas that would have the greatest impact on public health. AMR takes the approach of focusing on individual pathogens and “pathogen-focused” development. However, evaluating overall infections and their impact on patient outcomes reveals that 17 of 18 infection deaths are associated with susceptible pathogens. Here we discuss recentering on patients and patient outcomes instead of pathogens, and propose six suggestions on how a patient focus impacts areas and incentives for clinical research.
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