Antimicrobial Stewardship in the Emergency Department

被引：56

作者：

Pulia, Michael ^{[1
]}

Redwood, Robert ^{[2
,4
]}

May, Larissa ^{[3
]}

机构：

[1] Univ Wisconsin, Sch Med & Publ Hlth, BerbeeWalsh Dept Emergency Med, 800 Univ Bay Dr,Suite 300, Madison, WI 53705 USA

[2] Univ Wisconsin, Sch Med & Publ Hlth, Dept Family Med & Community Hlth, 1100 Delaplaine Ct, Madison, WI 53715 USA

[3] Univ Calif Davis, Dept Emergency Med, 4150 V St,Suite 2100, Sacramento, CA 95817 USA

[4] 2817 New Pinery Rd, Portage, WI 53901 USA

来源：

EMERGENCY MEDICINE CLINICS OF NORTH AMERICA | 2018年 / 36卷 / 04期

基金：

美国医疗保健研究与质量局;

关键词：

Antibiotics; Antimicrobial stewardship; Emergency department; Quality improvement; Infectious diseases; CARE-ASSOCIATED PNEUMONIA; URINARY-TRACT-INFECTION; COMMUNITY-ACQUIRED PNEUMONIA; PLUS TRIMETHOPRIM-SULFAMETHOXAZOLE; CLOSTRIDIUM-DIFFICILE INFECTION; SEXUALLY-TRANSMITTED INFECTIONS; ACUTE RESPIRATORY-INFECTIONS; TOP; 10; MYTHS; ANTIBIOTIC USE; ASYMPTOMATIC BACTERIURIA;

D O I：

10.1016/j.emc.2018.06.012

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The emergency department (ED) is the hub of the US health care system. Acute infectious diseases are frequently encountered in the ED setting, making this a critical setting for antimicrobial stewardship efforts. Systems-level and behavioral stewardship interventions have demonstrated success in the ED setting, but successful implementation depends on institutional support and the presence of a physician champion. Antimicrobial stewardship efforts in the ED should target high-impact areas: antibiotic prescribing for nonindicated respiratory tract conditions, such as bronchitis and sinusitis; overtreatment of asymptomatic bacteriuria; and using two antibiotics (double coverage) for uncomplicated cases of cellulitis or abscess.

引用

页码：853 / +

页数：21

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