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所有医院都应开展的五种基本活动

Discussion about essential versus desirable interventions in antimicrobial stewardship
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© UoD 和 BSAC

Australian Commission on Safety and Quality in Healthcare(澳大利亚医疗卫生质量与安全委员会)建议澳大利亚的医院在抗菌药物管理中开展五种基本活动和四种附加活动,具体如下:

所有医院都应开展的五种基本活动:

  • 实施与全国性指导原则一致并考虑到本地微生物学和抗菌药物敏感性特征的临床指导原则

  • 建立配方限制和审批系统,包括仅在具有临床应用合理性的前提下将广谱/新一代抗菌药物应用于患者。

  • 审核抗菌药物处方工作并干预和直接反馈给处方人员 — 这应至少包括重症监护患者

  • 通过收集和报告单位或各病房的使用数据、核查抗菌药物使用并利用高质量用药指标,监控抗菌药物处方的效果

  • 确保临床微生物学实验室使用符合医院抗菌药物治疗指导原则的敏感性测试结果选择性报告。

根据本地优先级和资源可视为“理想”活动的四种抗菌药物管理活动:

  • 对处方人员、药剂师和护士进行关于良好抗菌药物处方规范和细菌耐药性的培训

  • 实施医疗点干预,包括治疗合理化或降级、剂量优化,或肠胃外(静脉注射)改为口服

  • 使用信息技术,例如通过临床决策支持系统或在线审批系统实现电子处方

  • 每年发布本机构特有的细菌敏感性数据。

© UoD 和 BSAC
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抗菌素管理: 管理抗生素耐药性

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