Antibiotics treat infections caused by bacteria, but bacteria can evolve to resist these essential drugs. Over time, antibiotic misuse has rapidly accelerated the spread of such resistant bacteria, reducing the effectiveness of widely used antibiotics.
So how can we slow the rise of bacterial “superbugs” until antibiotic alternatives are developed? The answer is antibiotic stewardship.
Antibiotic stewardship aims to curb the misuse of antibiotics, which causes bacteria to develop resistance in the first place. This involves setting clear principles for how doctors prescribe antibiotics and how patients use them in various settings such as hospitals and nursing homes, and checking whether those principles are followed. This includes close tracking. Centers for Disease Control and Prevention (CDC).
The goal is to allow doctors to prescribe antibiotics for viral infections that cannot be treated with drugs, or to use “broad-spectrum” drugs that can kill many bacteria, for example, where “narrow-spectrum” drugs are effective. This is to prevent the administration of antibiotics to patients. . Broad-spectrum antibiotics are particularly problematic because they make a wide range of bacteria in the body resistant. And when they get a new one, tools of resistancedrug-resistant bugs are Easy to share Additional bacteria will develop in large numbers.
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“If we give too many antibiotics or give antibiotics more broadly than necessary, we create more antibiotic resistance in our patients and in our population.” Dr. Shruti Gohil4 principal researchers INSPIRE-ASP Trial — a federally funded study aimed at curbing the overuse of antibiotics in hospitals — told Live Science.
Controlling the misuse of antibiotics is expected to reduce the rate at which people become infected with multidrug-resistant organisms (MDROs), as well as reduce the chance that new MDROs will emerge and spread among the population. Masu.
“This is a marker that we all want to see, which is to reverse the MDRO epidemic,” said Gohil, who is also associate medical director of the Epidemiology and Infection Prevention Program at the University of California, Irvine. medicine.
How do we do that? There are a wide range of strategies.
Of course, one of the core strategies is to educate clinicians on the appropriate use of antibiotics, Gohil said. Hospitals can also use “descalation” to reconfirm doctors’ work. This involves checking the patient’s original prescription to determine whether a narrower, shorter course, or lower dose of the antibiotic is more appropriate. If your doctor determines that another antibiotic is a better choice than the one you originally selected, adjustments will be made quickly. “This is now the mainstay of antibiotic stewardship in hospitals,” she said.
Another common strategy in U.S. hospitals is to provide guidance about the best antibiotics to use for various infections within the electronic systems doctors use to order drugs. Hospitals may have limited access to ultra-broad-spectrum drugs and doctors may need to seek additional approval to use them, it added.
Speeding up diagnosis is another way doctors can help choose the right antibiotic or skip antibiotics altogether in cases of viral infections. When faced with a patient with an undiagnosed disease, Gohil said, clinicians often “err on the side of caution” by prescribing antibiotics that aren’t necessary. “One of the things that holds us back when trying to make decisions is that uncertainty.”
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The challenge, he noted, is that even the fastest diagnostic tests for bacterial infections can take several hours to produce results. And, except in the case of bloodstream infections, these initial results only indicate whether a particular microorganism is present in the body, not whether it is causing the patient’s illness. . To arrive at a final diagnosis, doctors must combine these test results with information that can be gleaned from the patient’s symptoms and additional tests, such as a chest X-ray.
In the future, rapid diagnostics that provide results at the bedside may ease this process, but that is still a long way off. “I’m not saying it’s impossible, but I don’t think it’s imminent,” Gohil said.
Beyond hospitals, clinicians nursing home and outpatient clinics such as primary care practices. dental clinic, similar education and regulatory oversight of antibiotic use is needed.and State and local health departments It plays an important role in coordinating and regulating those efforts.
Individual patients also have a role to play. For example, taking antibiotics as prescribed, not skipping doses, and not taking antibiotics originally prescribed to someone else. CDC advises.
“For example, anyone with bacterial resistance can shed and spread bacteria. So by reducing the risk for individuals, we hope to reduce the risk for the population as a whole.” Regarding the substance management program, Gohil said. “Reducing the pressure of antibiotics on certain people reduces the chance that resistance will develop.”
And beyond doctor visits, antibiotic management is also important. Important elements in livestock farmingThis is because MDROs that originate in food-producing animals can reach humans.
