Antibiotic Stewardship Strategies to Minimize Antibiotic Resistance While Maximizing Antibiotic Effectiveness

被引:32
|
作者
Cunha, Cheston B. [1 ]
Opal, Steven M. [1 ]
机构
[1] Brown Univ, Rhode Isl Hosp, Miriam Hosp, Div Infect Dis,Alpert Sch Med, 593 Eddy St,Phys Off Bldg,Suite 328, Providence, RI 02903 USA
关键词
Antibiotic stewardship; Antibiotic resistance; Optimal antimicrobial dosing; Pharmacokinetic considerations; Pharmacodynamic considerations; BETA-LACTAM ANTIBIOTICS; INTENSIVE-CARE-UNIT; ANTIMICROBIAL STEWARDSHIP; MULTIDRUG-RESISTANT; CRITICALLY-ILL; DOSE DAPTOMYCIN; SEPTIC SHOCK; PHARMACODYNAMICS; BACTEREMIA; SUSCEPTIBILITY;
D O I
10.1016/j.mcna.2018.04.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Empiric therapy of the septic patient in the hospital is challenging. Antibiotic stewardship is concerned with optimizing antibiotic use and minimizing resistance. Clinicians should avoid overcovering and over treating colonizing organisms in respiratory secretions and urinary catheters. Empiric therapy should take into account the prevalence of multidrug-resistant organisms in the hospital setting. The most effective resistance prevention strategy is to preferentially select a low resistance potential antibiotic, which should be administered in the highest possible dose without toxicity for the shortest duration to eliminate the infection.
引用
收藏
页码:831 / +
页数:14
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