(精选)Rational antibiotic use教学课件.pptVIP

Rational antibiotic use Dag Berild MD, DrMSci Department of Medicine Aker University Hospital, Oslo Cofusius 476 BC No country can afford not to have an antibiotic policy Rational antibiotic use Is giving the most effective and safest antibiotic against the pathogen with the most limited impact on the normal bacterial flora This will improve patient care and decrease costs The correlation between antibiotic use and resistanceMonnet DL. Emerg Infect Dis 2004; 10 (8): 1432-41 Antibiotics Should be targeted against pathogenic micro organisms They have a causal effect on diseases Other drugs work symptomatic or by being substitutes Effects on the patients= side effects The influence on the normal flora The evil circle of pneumonia Bacteriae Treatment Result Pneumococci Penicillin E. coli E. coli Ampicillin Klebsiella Klebsiella Cefuroxime Enterobacter Enterobacter Pipera/Genta. Pseudomonas Pseudomonas Cefta/tobramicin Candida Candida Amfotericin-B Deaf pt. + renal failure Side effects of antibiotics The treated patient: Toxic and allergic reactions Increased infection risk Other patients: Hospital infections with resistant bacteria Antibiotics should not be used as Antipyreticum for patients Sedatives for doctors The aim of an antibiotic policy To select the patients that need to be treated To have all antibiotics available Avoid unnecessary antibiotic use The patient with fever Careful patient history and physical examination Relevant microbiological samples Observation Septicaemia of unknown origin is very rare No standard treatment for septicaemia