原创力文档procon debate should antimicrobial stewardship programs be adopted universally in the intensive care unit圣保罗市辩论抗菌管理程序应采用普遍在重症监护室.pdfVIP
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procon debate should antimicrobial stewardship programs be adopted universally in the intensive care unit圣保罗市辩论抗菌管理程序应采用普遍在重症监护室
George and Morris Critical Care 2010, 14:205
/content/14/1/205
R E V I E W
Pro/con debate: Should antimicrobial stewardship
programs be adopted universally in the intensive
care unit?
1 2
Philip George and Andrew M Morris *
while producing the fewest possible side eff ects and the
Abstract
lowest risk for subsequent resistance [2]. Antimicrobial
You are director of a large multi-disciplinary ICU. stewardship programs may contain a variety of inter-
You have recently read that hospital-wide antibiotic ventions that are complementary to eff ective infection
stewardship programs have the potential to improve prevention and control programs.
the quality and safety of care, and to reduce the Inappropriate antimicrobial usage is a signifi cant
emergence of multi-drug resistant organisms and problem, with approximately 50% of antimicrobial usage
overall costs. You are considering starting one of being unnecessary or suboptimal in hospital, community
these programs in your ICU, but are concerned about or ambulatory settings [3,4]. A recent study showed that
the associated infrastructure costs. You are debating approximately 20% of patients admitted to the ICU with
whether it is worth bringing the concept forward to Clostridium difficile-associated diarrhoea were receiving
your hospital’s administration to consider investing in. antibiotics without any obvious evidence of infection,
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