從細菌的抗藥性談抗生素管理的重要性

Emphasis on Antibiotic Stewardship for Decreasing Antibiotic Resistance

林明鋒(Ming-Feng Lin)

《感染控制雜誌》 22卷3期 (2012/06) Pp. 115-123

https://doi.org/10.6526/ICJ.201206_22(3).0003

摘要

隨著抗生素被廣泛使用來治療人類的細菌感染，多重抗藥性也隨之出現威脅人類的健康，這些超級病菌正使得醫療照護系統面臨空前的挑戰。我們方面面臨人用抗生素不當使用對細菌抗藥性的巨大衝擊，方面又遭遇到動物用抗生素過度浮濫對抗藥基因出現在食物鏈中所帶來的深遠影響。雖然抗生素使用會導致細菌抗藥性的增加，但是面對嚴重的細菌感染，及時給予抗生素卻又是治療成功與否最關鍵的因素。研究證實抗生素用量的減少能夠減緩，甚至逆轉抗藥性增加的趨勢。因此，建立一套有效的抗生素管理系統來協助臨床醫師面對此一兩難局面，實有其必要性。抗生素管理計畫係利用兩個核心策略配合八大補強策略，透過個過程來監測及最佳化抗生素之使用，其目的在於減少抗藥性、控制醫療責用及追求病人安全。

關鍵字

抗生素管理 ； 抗藥性

並列摘要

Although antibiotics are used widely to treat bacterial infections in humans, multidrug resistance appears to threaten the health of humankind. Superbugs are an unprecedented challenge for the health care system. Currently, there are increasing numbers of antibiotic-resistant bacteria due to the inappropriate use of antibiotics by humans. Additionally, we are confronted by the prevalence of resistance genes in the food chains due to overuse of antibiotics in animals. Although antibiotic use will lead to an increase in bacterial resistance, the timely prescription of antibiotics is a key factor in successful treatment of severe bacterial infections. Studies have shown that the reduction in antibiotic use may slow down, and hence, reverse the increasing tendency towards antibiotic resistance. Therefore, it is necessary to establish an effective antibiotic stewardship system to help clinicians resolve this problem. The antibiotics stewardship plan is a program aimed at monitoring and optimizing antibiotic use through 2 core strategies with 8 supplemental strategies. The aims of the antibiotic stewardship are to reduce antibiotic resistance, control costs, and ensure patient safety.

並列關鍵字

Antibiotic stewardship ； resistance