我国抗菌药物临床应用与细菌耐药的现状与变迁-第三军医.doc

PAGE PAGE 3 抗菌药合理应用：我们做了什么？离我们还有多远？ 王明贵 （200040上海，复旦大学附属华山医院抗生素研究所） [关键词] 抗菌药物；合理应用；抗菌药管理 [中图法分类号] [文献标志码] A Rational use of antibacterial agents: What have we done? How far from us? Wang Minggui (Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, China) [Abstract] Antibacterial agents were overused and resulted in high bacterial resistance rates in China. Antibacterial agents were used in 69% of inpatients and 21.8% of outpatients in China in 2009. Extended-spectrum β-lactamase (ESBL) producing strains accounted for 55% in Escherichia coli and 34% in Klebsiella pneumoniae in 2012. Many measures have been taking in recent years by Healthcare administrators and professionals for the purpose of rational use of antibacterial agents, including the establishment of Guiding Principle of Clinical Use of Antibacterial Agents and Regulations for Clinical Application of Antibacterial Agents, and implementation of three years’ nationwide inspection on the rational use of antibacterial agents in hospitals. A lot of progresses have been made for clinical use of antibacterial agents in recent years such as the decrease use of antibacterial agents including prophylactic use in surgery. More works need to be carried out to further improve the rational use of antibacterial agents in the future. Antibacterial agents should be managed professionally and persistently with less administration intervention as do in many countries around the world. [Key words] Antibacterial agents; Rational use; Antibiotic stewardship Corresponding author: Wang Minggui, E-mail: mgwang@ [通信作者] 王明贵，男，博士，主任医师，教授，博士生导师。现任复旦大学抗生素研究所常务副所长，为国家自然科学基金第十三、十四届医学科学部专家评审组成员，卫生部合理用药专家委员会抗菌药物专业组专家,上海领军人才、上海市优秀学科带头人及上海市医学领军人才。担任上海医学会感染与化疗专业委员会主任委员、中国药学会药物临床评价研究专业委员会委员、全球华人临床微生物暨感染学会理事。为《中华传染病杂志》、《中国抗感染化疗杂志》等12本杂志编委，5本为英文国际刊物，是International Journal of Antimicrobial Agents (IF 4.4)及Journal of Global Antimicrobial Resistance 杂志的编辑。作为项目负责人承担科技部“973”项目（首席科学家）、国家自然科学基金重大国际