{"title":"概述:抗菌药物管理计划的实施和核心要素","authors":"","doi":"10.1016/j.cegh.2024.101543","DOIUrl":null,"url":null,"abstract":"<div><p>Antimicrobial Stewardship Programme (ASP) is an organizational or system-wide health-care strategy that promotes optimal antibiotic use through the implementation of evidence-based interventions. The Indian Council of Medical Research (ICMR) issued the ASP guidelines in 2018, that are applicable for reducing antimicrobial resistance (AMR) effects. In comparison with older children, neonates receive broad spectrum antimicrobials more frequently. As neonates are having high risk of morbidity and mortality, so they are more susceptible to early upgradation of antibiotic. Antimicrobial use in terms of daily dose, cost, and treatment days, antimicrobial adverse events, resistance tendencies, intervention, and monitoring can all be utilized to assess an ASP's progress. An effective antimicrobial stewardship programme requires the presence of at least one infectious diseases-trained physician who devotes a portion of their time to the program's design, implementation, and operation. A pharmacist's most critical duties and responsibilities include developing, reviewing, and implementing antimicrobial stewardship (AMS) guidelines and policies, providing clinical guidance to optimise antimicrobial prescribing and usage, monitoring, auditing, and providing feedback. Clinical microbiology services are an essential component of successful AMS systems. Challenges in implementing Stewardship program are competition among doctors, absence of champion, utility value of an antibiogram, poor enforcement of regulations, time constraints, lack of inter-departmental co-ordination, minimal supporting facilities. A combination of particular antibodies, organism-specific bacteriophages, and small molecules might be used in future therapies that inhibit specific virulence factors, and antibiotic resistance-fighting drugs.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424000393/pdfft?md5=801e1694db9e3a7d82b43a33ec7dfff9&pid=1-s2.0-S2213398424000393-main.pdf","citationCount":"0","resultStr":"{\"title\":\"An overview: Implementation and core elements of antimicrobial stewardship programme\",\"authors\":\"\",\"doi\":\"10.1016/j.cegh.2024.101543\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Antimicrobial Stewardship Programme (ASP) is an organizational or system-wide health-care strategy that promotes optimal antibiotic use through the implementation of evidence-based interventions. 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引用次数: 0
摘要
抗菌药物管理计划(ASP)是一种组织或全系统范围内的医疗保健战略,通过实施循证干预措施来促进抗生素的优化使用。印度医学研究理事会(ICMR)于2018年发布了ASP指南,适用于减少抗菌药耐药性(AMR)的影响。与年龄较大的儿童相比,新生儿接受广谱抗菌药物治疗的频率更高。由于新生儿发病和死亡风险高,因此他们更容易早期升级抗生素。抗菌药物的日使用剂量、成本和治疗天数、抗菌药物不良事件、耐药性倾向、干预和监测都可以用来评估 ASP 的进展情况。有效的抗菌药物管理计划要求至少有一名接受过传染病培训的医生参与其中,并将部分时间投入到计划的设计、实施和运作中。药剂师最关键的职责和责任包括制定、审查和实施抗菌药物管理(AMS)指南和政策,提供临床指导以优化抗菌药物的处方和使用,进行监控、审计和提供反馈。临床微生物学服务是成功的抗菌药物管理制度的重要组成部分。实施 "抗菌药物管理计划 "面临的挑战包括:医生之间的竞争、缺乏倡导者、抗生素图谱的实用价值、法规执行不力、时间限制、缺乏跨部门协调以及配套设施极少。特定抗体、生物体特异性噬菌体和小分子的组合可能会被用于未来抑制特定毒力因子和抗生素耐药性药物的疗法中。
An overview: Implementation and core elements of antimicrobial stewardship programme
Antimicrobial Stewardship Programme (ASP) is an organizational or system-wide health-care strategy that promotes optimal antibiotic use through the implementation of evidence-based interventions. The Indian Council of Medical Research (ICMR) issued the ASP guidelines in 2018, that are applicable for reducing antimicrobial resistance (AMR) effects. In comparison with older children, neonates receive broad spectrum antimicrobials more frequently. As neonates are having high risk of morbidity and mortality, so they are more susceptible to early upgradation of antibiotic. Antimicrobial use in terms of daily dose, cost, and treatment days, antimicrobial adverse events, resistance tendencies, intervention, and monitoring can all be utilized to assess an ASP's progress. An effective antimicrobial stewardship programme requires the presence of at least one infectious diseases-trained physician who devotes a portion of their time to the program's design, implementation, and operation. A pharmacist's most critical duties and responsibilities include developing, reviewing, and implementing antimicrobial stewardship (AMS) guidelines and policies, providing clinical guidance to optimise antimicrobial prescribing and usage, monitoring, auditing, and providing feedback. Clinical microbiology services are an essential component of successful AMS systems. Challenges in implementing Stewardship program are competition among doctors, absence of champion, utility value of an antibiogram, poor enforcement of regulations, time constraints, lack of inter-departmental co-ordination, minimal supporting facilities. A combination of particular antibodies, organism-specific bacteriophages, and small molecules might be used in future therapies that inhibit specific virulence factors, and antibiotic resistance-fighting drugs.
期刊介绍:
Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.